Fresenius Medical Care AG (FMS) 2025 Q1 法說會逐字稿

Ladies and gentlemen, welcome to the Q1 2025 of Fresenius Medical Care earnings conference call.

女士們，先生們，歡迎參加費森尤斯醫療保健 2025 年第一季財報電話會議。

I'm Sandra, the Chorus Call operator.

我是桑德拉，合唱團的接線生。

(Operator Instructions) The conference is being recorded.

（操作員指示）會議正在錄音。

(Operator Instructions) The conference must not be recorded for publication or broadcast.

（操作員指示）會議不得錄製以供出版或廣播。

At this time, it's my pleasure to hand over to Dr. Dominik Heger. Please go ahead, sir.

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 first-quarter 2025. I know that this is a very tough day, with many companies in the sector reporting today.

謝謝你，桑德拉。歡迎大家參加我們 2025 年第一季的財報電話會議。我知道這是非常艱難的一天，今天該行業的許多公司都要報告。

Nevertheless, thank you for joining us today. As always, I would like to 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.

儘管如此，還是感謝您今天加入我們。像往常一樣，我想首先提及我們在安全港聲明中以及我們今天早些時候分發的演示文稿和所有材料中的警告性語言。

For further details concerning risks and uncertainties, please refer to these documents and to our SEC filings. As always, we will have 60 minutes for the call.

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。像往常一樣，我們將有 60 分鐘的通話時間。

To give everyone the chance to ask questions, we would like to limit the number of questions to two, like in the past. And it would be great if we could make it work again, as always.

為了讓每個人都有機會提問，我們想像過去一樣將問題數量限制為兩個。如果我們能夠像往常一樣讓它再次運轉起來，那就太好了。

Let me now welcome Helen Giza, CEO and Chair of the Management Board; and Martin Fischer, our Chief Financial Officer. 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)；以及我們的財務長馬丁·菲舍爾 (Martin Fischer)。海倫，請你發言。

Thank you, Dominik. I'd like to extend a warm welcome to everyone on the call. Thank you for your continued interest in Fresenius Medical Care.

謝謝你，多米尼克。我謹向電話會議中的各位嘉賓表達熱烈的歡迎。感謝您對費森尤斯醫療保健的持續關注。

I'm pleased to report that we are off to a great start in 2025. Our first-quarter performance further underscores the strength in the execution of our current strategic plan. With the start of the third and final year of our plan, I'm thrilled with our team's energy and focus, maintaining momentum and delivering continued operational and financial progress.

我很高興地告訴大家，我們在 2025 年已經有了一個好的開始。我們第一季的業績進一步凸顯了我們目前策略計畫執行的實力。隨著我們計劃的第三年也是最後一年的開始，我對我們團隊的活力和專注力感到非常興奮，他們保持著發展勢頭並持續取得營運和財務方面的進步。

I will begin my prepared remarks on slide 4. In the first quarter, we delivered strong organic revenue growth of 5%, with positive contributions from both Care Delivery and Care Enablement.

我將從第四張投影片開始我的準備好的發言。第一季度，我們實現了 5% 的強勁有機收入成長，其中護理服務和護理支援均做出了積極貢獻。

Despite a severe flu season increasing missed treatments, we realized stable same market treatment growth in the United States. This was possible due to continuously improving underlying referral trends, which were supported by the tremendous operational improvements made within Care Delivery.

儘管嚴重的流感季節導致漏治病例增多，但我們在美國實現了同類市場治療的穩定成長。這是由於不斷改善的潛在轉診趨勢而實現的，而這得益於護理服務領域在營運方面取得的巨大改進。

Our FME25 transformation program continued its momentum, delivering EUR68 million in additional sustainable savings of our targeted EUR180 million for the year.

我們的 FME25 轉型計畫持續保持強勁勢頭，在全年 1.8 億歐元的目標基礎上，額外實現了 6,800 萬歐元的可持續節約。

We achieved 11% operating income growth, consistent with the expected phasing of our full year outlook, positioning us well for even greater growth in the quarters to come.

我們的營業收入實現了 11% 的成長，與我們對全年前景的預期階段一致，為我們在未來幾季實現更大的成長做好了準備。

Thanks to robust cash flow development and our strict financial discipline, our net leverage ratio improved to 2.8x, which is well below our self-imposed target range. While tariffs have certainly been a prominent topic this year-to-date, recent changes in tariffs did not have an impact in the first quarter. Also, for the financial year 2025, we currently expect only a very limited impact from both U.S.

由於強勁的現金流發展和嚴格的財務紀律，我們的淨槓桿率改善至 2.8 倍，遠低於我們自己設定的目標範圍。雖然關稅無疑是今年迄今為止的一個突出話題，但最近的關稅變化並沒有對第一季產生影響。此外，對於 2025 財年，我們目前預期美國的影響將非常有限。

and any global retaliatory tariffs. Overall, the first quarter developed well in line with our expectations, and we are, therefore, confirming our full year outlook.

以及任何全球報復性關稅。總體而言，第一季的發展符合我們的預期，因此我們確認了全年展望。

Turning to Slide 5. Here, I would like to highlight recent developments in each of our operating segments, beginning with Care Delivery. In the U.S., the stable or very slightly positive volume development reflected a 40 basis point impact from missed treatments driven by the severe flu season.

翻到幻燈片 5。在這裡，我想重點介紹我們各個營運部門的最新發展，首先是護理服務部門。在美國，穩定或略微積極的銷售發展反映了嚴重流感季節導致的錯過治療造成的 40 個基點的影響。

We experienced peak flu impact in February and March. Prior to that, we realized relatively strong volume development in January. At the same time, we are encouraged by the accelerating number of referrals, which have helped to offset the impact from flu-related missed treatments.

我們在二月和三月經歷了流感高峰。在此之前，我們在一月份實現了相對強勁的銷售發展。同時，我們對轉診數量的增加感到鼓舞，這有助於抵消因流感相關治療而錯過治療的影響。

Throughout the quarter, we saw improving trends in patient referrals and the results of our operational improvements continuing from the second half of last year. This includes our efforts to streamline our admissions process and reduce patient cancellations.

整個季度，我們看到患者轉診的趨勢有所改善，並且我們的營運改善成果也延續了去年下半年的成果。這包括我們努力簡化入院流程並減少患者取消就診的情況。

Therefore, we continue to expect same market treatment growth of 0.5% plus for the U.S. in 2025. While we have not given a specific phasing, we would expect a similar trajectory as last year with Q1 as the low point and stronger performance following throughout the year.

因此，我們繼續預期 2025 年美國同類市場治療成長率將超過 0.5%。雖然我們沒有給出具體的分階段，但我們預計其軌跡與去年類似，第一季為最低點，全年表現將更加強勁。

While our same market treatment growth adjusts for the number of dialysis days, having one fewer dialysis day in the quarter creates a headwind for absolute volume development and utilization. In our international markets, we saw strong same market treatment growth accelerate to 2.5%.

雖然我們相同的市場治療成長會根據透析天數進行調整，但本季透析天數減少一天會對絕對容量開發和利用帶來阻力。在我們的國際市場上，我們看到同類市場治療成長強勁，加速至 2.5%。

This is an encouraging indicator for these markets as well as an outlook for the U.S. recovery. Our value-based care business contributed to overall revenue growth. We saw lives under management increase from around 130,000 at the end of 2024 to around 148,000 at the end of March.

這對這些市場來說是一個令人鼓舞的指標，也是美國經濟復甦的前景。我們基於價值的護理業務促進了整體收入的成長。我們看到管理的生命從 2024 年底的約 13 萬人增加到 3 月底的約 148,000 人。

Despite headwinds from one less dialysis day and the severe flu season, we maintained our operating income development at a stable level.

儘管透析日減少一天以及流感季節嚴重，我們的營業收入發展仍保持穩定。

Our 2025 outlook anticipated a lower contribution from the first quarter in Care Delivery, so all in line with expectations. Our Care Delivery earnings were supported by favorable rate and mix development as well as a positive impact from phosphate binders.

我們對 2025 年的展望預計第一季在醫療服務方面的貢獻會較低，因此一切都符合預期。我們的護理服務收益受到有利的費率和組合開發以及磷酸鹽結合劑的積極影響的支持。

Within Care Delivery, we are continuing to prepare for the rollout of high-volume hemodiafiltration or HDF for short. In the U.S., our first U.S. pilot program has grown from a few patients to 11 currently treated on our new 5008x machine.

在醫療服務領域，我們正在繼續為推出高容量血液透析濾過（簡稱 HDF）做準備。在美國，我們的第一個美國試點計畫已經從幾名患者發展到目前使用我們的新 5008x 機器接受治療的 11 名患者。

We are well positioned to expand that further as we approach the official launch at the end of the year. Turning to Care Enablement. After a strong Q4 last year, Care Enablement delivered a strong first quarter with solid volume growth in all regions and continued positive pricing momentum.

隨著年底正式發布的臨近，我們已做好進一步擴大這一範圍的準備。轉向護理支援。繼去年第四季表現強勁之後，Care Enablement 在第一季也表現出色，所有地區的銷售量均實現穩健成長，定價動能持續向好。

We realized additional sustainable savings as part of our FME25 transformation program, driven by further optimization of our manufacturing and supply chain footprint. I'm pleased to report that our Care Enablement margin further improved to 8.3% for the first time it entered its target margin band of 8% to 12%.

作為 FME25 轉型計劃的一部分，我們透過進一步優化製造和供應鏈足跡實現了額外的永續節約。我很高興地報告，我們的護理支持利潤率進一步提高至 8.3%，首次進入 8% 至 12% 的目標利潤率區間。

While there is more work to be done, if you remember where we came from, this is a tremendous achievement and positions this segment for further growth and margin expansion beyond 2025. Not only from a Care Delivery perspective, but also from a Care Enablement perspective, we are actively preparing to bring transformational innovation to the U.S. market with the rollout of the 5008x.

雖然還有很多工作要做，但如果你還記得我們來自哪裡，這是一個巨大的成就，並為該領域在 2025 年以後的進一步增長和利潤擴大奠定了基礎。不僅從醫療服務提供的角度，而且從醫療服務支援的角度，我們正在積極準備透過推出 5008x 為美國市場帶來變革性創新。

We are well on track for the launch at the end of the year, and we look forward to sharing more detail at our CMD on June 17. I'll now hand over to Martin to take you through the first quarter financial performance in more detail.

我們正按計劃於年底推出該產品，我們期待在 6 月 17 日的 CMD 上分享更多細節。現在我將讓馬丁向大家更詳細地介紹第一季的財務表現。

Thank you, Helen, and welcome to everyone on the call also from my side. I'll pick up on Slide 7. In the first quarter, we achieved solid organic revenue growth of 5% with contributions from both segments. At constant currency, revenue increased by 1%. The muted revenue development reflects the successful execution of our portfolio optimization plan.

謝謝你，海倫，我也代表我歡迎電話會議中的各位。我將從第 7 張投影片開始。第一季度，在兩個部門的貢獻下，我們實現了 5% 的穩健有機收入成長。以固定匯率計算，收入增加了 1%。收入成長放緩反映了我們投資組合優化計劃的成功執行。

Divestitures negatively impacted our revenue development by 260 basis points. As a reminder, we decided not to adjust our numbers in the fiscal year 2024 and 2025 for the divestitures that were closed in those years. We decided to absorb the revenue and operating income effects of having sold the business in our guidance range for the respective year.

資產剝離對我們的收入發展產生了 260 個基點的負面影響。提醒一下，我們決定不針對 2024 和 2025 財年已完成的資產剝離調整我們的數字。我們決定吸收出售該業務對相應年度指導範圍內的收入和營業收入的影響。

Operating income, excluding special items, increased by 11% on a constant currency basis, primarily driven by growth in our Care Enablement segment. This reflects the expected phasing for our 2025 outlook.

不包括特殊項目的營業收入以固定匯率計算成長了 11%，這主要得益於我們護理支援部門的成長。這反映了我們對 2025 年展望的預期階段。

Special items negatively affected group operating income by EUR126 million. This mainly includes costs relating to portfolio optimization and our FME25 transformation program as well as negative effects from the remeasurement of our investment in Humacyte.

特殊項目對集團營業收入產生了1.26億歐元的負面影響。這主要包括與投資組合優化和我們的 FME25 轉型計劃相關的成本，以及重新衡量我們對 Humacyte 的投資所產生的負面影響。

Next, on Slide 8. This slide highlights the drivers of our year-over-year margin development. We realized a 90 basis point margin increase, largely driven by growth in our Care Enablement segment.

接下來，請看投影片 8。這張投影片重點介紹了我們利潤率逐年成長的驅動因素。我們的利潤率成長了 90 個基點，這主要得益於護理支援部門的成長。

This offset the slightly negative Care Delivery contribution, which reflected the impact of a severe flu season and one less dialysis day. I will review the drivers when we look at the segments in detail. Favorable contributions from corporate included the positive valuation effect of virtual power purchase agreements amounting to EUR3 million in the first quarter.

這抵消了略微負面的醫療服務貢獻，這反映了嚴重的流感季節和減少一天的透析時間的影響。當我們詳細研究各個部分時，我將回顧驅動因素。企業方面的有利貢獻包括第一季虛擬購電協議的正面估值效應，金額達 300 萬歐元。

It is worth noting that foreign exchange translation had a beneficial effect on our business in the first quarter and contributed to the growth with EUR11 million. Moving on to Slide 9.

值得注意的是，外匯折算對我們的第一季業務產生了有益的影響，並貢獻了1,100萬歐元的成長。移至幻燈片 9。

Care Delivery showed strong organic revenue growth of 4%, driven by both Care Delivery U.S. and Care Delivery International. In the U.S., our growing value-based care business supported revenue development along with favorable rate and payer mix development.

在 Care Delivery U.S. 和 Care Delivery International 的推動下，Care Delivery 的有機收入強勁成長 4%。在美國，我們不斷成長的基於價值的護理業務支持了收入發展以及優惠的費率和付款人組合發展。

This compensated for the muted same market treatment growth, reflecting higher levels of missed treatments driven by the flu season. As mentioned by Helen, we also realized solid international revenue growth, supported by accelerated same market treatment growth of 2.5% in those markets.

這彌補了同一市場治療成長放緩的現象，反映出流感季節導致的錯過治療數量增加。正如海倫所說，我們也實現了穩健的國際收入成長，這得益於這些市場同市場治療費用成長 2.5%。

The revenue development was negatively impacted by one less dialysis day. Additionally, our portfolio optimization plan negatively impacted Care Delivery revenue development by 370 basis points. We expect the headwind from our portfolio optimization to reduce over the course of the year.

透析日減少一天對收入發展產生了負面影響。此外，我們的投資組合最佳化計畫對醫療服務收入發展產生了 370 個基點的負面影響。我們預計，投資組合優化帶來的阻力將在今年內減少。

Despite the headwinds faced in this first quarter, Care Delivery maintained its operating income contribution at a stable level, even slightly expanding its margin to 9.3%. Earnings were supported by favorable rate and mix developments as well as a positive impact from phosphate binders.

儘管第一季面臨阻力，Care Delivery 仍維持了穩定的營業收入貢獻，利潤率甚至略微擴大至 9.3%。獲利受到有利的利率和組合發展以及磷酸鹽黏合劑的積極影響的支持。

Care Delivery earnings also benefited from FME25 savings. These earnings developments were offset by labor and inflation costs in the quarter, which developed in line with our expectations. Let us have a closer look at the developments in Care Enablement on Slide 10.

醫療服務收入也受惠於 FME25 節省。這些獲利發展被本季的勞動力和通貨膨脹成本所抵消，這些成本的發展符合我們的預期。讓我們仔細看看幻燈片 10 上的護理支援的進展。

In the first quarter, Care Enablement continued to show strong revenue growth, supported by 5% organic growth. This development is mainly attributable to solid volume growth in all regions and continued positive pricing momentum globally.

第一季度，Care Enablement 繼續呈現強勁的營收成長，得益於 5% 的有機成長。這一發展主要歸功於所有地區銷售的穩健成長以及全球持續積極的定價動能。

In line with our expectations, volume-based procurement in China was again supportive of volume growth, but a headwind to pricing. The segment showed a significant 49% increase in operating income, resulting in a margin increase of 240 basis points. With an 8.3% margin, Care Enablement also reached its target margin band. This reflected continued execution of our FME25 transformation program as well as improved volume and price effects, which more than offset anticipated deflationary pressures. Moving to Slide 11.

正如我們的預期，中國的大量採購再次支持了銷售成長，但對定價卻造成了阻礙。該部門的營業收入大幅增加了49%，利潤率也增加了240個基點。Care Enablement 的利潤率為 8.3%，也達到了其目標利潤率範圍。這反映了我們FME25轉型計劃的持續執行以及數量和價格效應的改善，這足以抵消預期的通貨緊縮壓力。移至投影片 11。

In the first quarter, the relatively low operating cash flow was driven by seasonality in invoicing in line with our expectations. We realized a strong increase of 28% against last year's quarter due to improved operating working capital.

第一季度，相對較低的經營現金流是由發票的季節性因素造成的，這符合我們的預期。由於營運資金的增加，我們實現了較去年同期 28% 的強勁成長。

Consistent with our current strategic priorities, we further reduced both our total debt and lease liabilities and total net debt and lease liabilities compared to the prior year period. As a result of our continued strict financial discipline, our net leverage ratio improved to 2.8x. We remain comfortable being below our self-imposed target corridor of 3 to 3.5x.

與我們目前的策略重點一致，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。由於我們持續嚴格的財務紀律，我們的淨槓桿率改善至 2.8 倍。我們仍然樂意維持低於我們自己設定的 3 至 3.5 倍的目標區間。

Following the quarter end in early April, we took advantage of the favorable market conditions and our improved credit rating outlook to successfully place 2 bond tranches with an aggregate volume of EUR1.1 billion.

四月初季結束後，我們利用有利的市場條件和改善的信用評等前景，成功發行了兩批債券，總額為 11 億歐元。

We used some of the funds to buy back approximately EUR300 million of bond maturing in 2026. We are planning to provide an update on our future capital allocation plans at our upcoming Capital Markets Day in June. I will now hand back to Helen to review our outlook.

我們利用部分資金回購了2026年到期的約3億歐元債券。我們計劃在六月即將舉行的資本市場日上提供有關未來資本配置計劃的最新資訊。現在我將把我們的展望交還給海倫。

Thank you, Martin. I will pick up with our outlook on Slide 13. Given our first quarter performance and current expectations for the remainder of 2025, we are confident to deliver a strong performance in 2025 and are confirming our full year outlook.

謝謝你，馬丁。我將在第 13 張投影片上繼續闡述我們的展望。鑑於我們第一季的業績以及對 2025 年剩餘時間的當前預期，我們有信心在 2025 年取得強勁業績，並確認我們的全年展望。

We continue to expect a positive to a low single-digit percent revenue development, and our Q1 operating income developed in line with our expectations as we anticipated a relatively lower contribution from the first quarter. Therefore, we expect operating income to grow by a high teens to high 20s percent rate compared to prior year.

我們繼續預期收入將以正數至低個位數百分比成長，並且由於我們預期第一季的貢獻相對較低，因此我們的第一季營業收入符合我們的預期。因此，我們預期營業收入將比前一年成長百分之十幾到二十幾個百分點。

I will finish my prepared remarks on Slide 14. Finally, I am looking forward to seeing many of you on June 17 in London for our Capital Markets Day. We plan to share the details of our strategy and capital allocation priorities.

我將在第 14 張投影片上結束我準備好的演講。最後，我期待著 6 月 17 日在倫敦舉行的資本市集日活動中與大家見面。我們計劃分享我們的策略和資本配置重點的細節。

In addition, we have some interesting deep dive breakout sessions and a product show that we are excited about. If you have not already registered, please do connect with Investor Relations as our registration will close on May 15.

此外，我們還舉辦了一些有趣的深入分組會議和令我們興奮的產品展示。如果您尚未註冊，請聯絡投資者關係部門，我們的註冊將於 5 月 15 日截止。

With that, I will now hand back to Dominik to start the Q&A.

現在，我將把話題交還給 Dominik，開始問答環節。

Thank you, Helen and Martin, for your prepared remarks. (Operator Instructions) With that, I hand over to Sandra to open the Q&A, please.

感謝海倫和馬丁的準備發言。（操作員指示）接下來，我請桑德拉開始問答環節。

(Operator Instructions) Back over to you, sir.

（操作員指示）回到您這裡，先生。

Thank you, Sandra. The first question comes from Victoria from Berenberg.

謝謝你，桑德拉。第一個問題來自貝倫貝格的維多利亞。

The first one is just on what you are seeing in April trading so far in the U.S.? I know Q1 was pretty volatile. So just an update on April would be helpful and how this gives you confidence to reiterate your full year guidance for the 50 bps or more of growth? And then the second question is just on phosphate binders. What benefit did those have in Q1?

第一個問題是關於您看到美國四月的交易情況嗎？我知道第一季相當不穩定。因此，僅僅提供 4 月的更新資訊就會有所幫助，這如何讓您有信心重申全年增長 50 個基點或更高的預期？第二個問題是關於磷酸鹽結合劑的。這些對第一季有什麼好處？

And do you still expect the, I think, EUR50 million to EUR100 million operating income benefit for the full year?

我認為，您是否仍預計全年營業收入將獲利 5,000 萬至 1 億歐元？

Victoria, I'll take the first question, and Martin can take the second question on the binders. Obviously, the flu season hit hard in February and March. It rose pretty quickly and came back down. We are encouraged by what we see with the underlying referrals. That is a very strong leading indicator for us.

維多利亞，我來回答第一個問題，馬丁可以回答有關活頁夾的第二個問題。顯然，二月和三月是流感季節的重災區。它上升得很快，然後又下降了。我們對所看到的潛在推薦感到鼓舞。對我們來說，這是一個非常強勁的領先指標。

I think what we'll also see in Q2 is the mortality effect, obviously, with a 6- to 8-week lag on the flu data. Obviously, we haven't seen that kind of data fully for April yet. I think we've even closed the month, so -- but we're encouraged by the kind of the weekly numbers that we're seeing, and we would expect that underlying inflow trends to continue.

我認為我們在第二季度還會看到死亡率的影響，顯然流感數據會落後 6 到 8 週。顯然，我們還沒有看到四月的完整數據。我想我們已經結束了這個月，所以——但我們看到的每週數據讓我們感到鼓舞，我們預計潛在的流入趨勢將會持續下去。

And we do feel confident with the phasing that we always see in Q1 that we will continue on a positive trajectory through the end of the year and confident with our 0.5 plus for the year.

我們確實對第一季的階段性進展充滿信心，我們將繼續保持積極的發展軌跡直至年底，並對今年的 0.5 以上充滿信心。

Yes. And Victoria, on the phosphate binders. So quarter 1 developed in line with expectations, and we have outlined the full fiscal year effect. And given that with the phosphate binders going to the bundle, the ASPs used to start higher and then only being going downwards and revised throughout the fiscal year.

是的。維多利亞 (Victoria) 談論磷酸鹽結合劑。因此，第一季的發展符合預期，並且我們已經概述了整個財年的影響。並且考慮到隨著磷酸鹽結合劑進入捆綁銷售，平均售價起初較高，然後在整個財政年度內持續下降並進行修訂。

We did see a seasonal or a stronger start into the fiscal year and had a double-digit million effect that contributed to the positive quarter.

我們確實看到了財年的季節性或更強勁的開局，並且產生了兩位數的數百萬效應，為積極的季度做出了貢獻。

The next caller is Victoria from Citi. Welcome back Victoria -- sorry, Veronika. Welcome back. See I even missed your name. It's been a long away so long.

下一個打電話的人是花旗銀行的維多利亞。歡迎回來維多利亞——對不起，維羅妮卡。歡迎回來。瞧，我甚至忘記了你的名字。已經很久很久了。

Welcome back.

歡迎回來。

Helen and Martin, great to be back. I'll keep it 2, please. The first one is just the revenue per treatment trend in the first quarter in the U.S., it seems like it held up particularly well. Just curious, Helen, if you can give us an update on what you're seeing from a commercial perspective and for Medicare Advantage and whether this is something that is sustainable? And I guess, to what extent it was flattered by the phosphate binder dynamic?

海倫和馬丁，很高興回來。請給我 2 個。第一個是美國第一季每次治療的收入趨勢，看起來表現特別好。海倫，我只是好奇，你能否從商業角度和醫療保險優勢計劃的角度向我們介紹一下你的看法，以及這是否可持續？我猜想，磷酸鹽結合劑的動態在多大程度上使它受寵若驚？

So that's my first question. And my second question is around Care Enablement. Congratulations in getting the margin into the target band. Martin, are you able to give us a bit of color on what was the contribution from pricing to revenue growth and profitability? And how much scope there is to do more as we go through this year?

這是我的第一個問題。我的第二個問題是關於護理支援。恭喜您將利潤率納入目標區間。馬丁，您能否向我們詳細介紹定價對營收成長和獲利能力的貢獻？今年我們還有多少事情要做？

Welcome back, Veronika. I'll take the first one on RPT. Yes, look, we are seeing continued price and mix improvement in development there. Obviously, with the PPS rate increase as well as the -- what we have always spoken to this past year or so about kind of moderate price increases, that 1% to 2% price increase across the full portfolio of payers.

歡迎回來，維羅妮卡。我將選擇 RPT 上的第一個。是的，我們看到那裡的價格和組合發展持續改善。顯然，隨著 PPS 費率的上漲以及——我們在過去一年左右一直在談論的適度價格上漲，即所有付款人的價格上漲 1% 至 2%。

So I think we're comfortable with how that trend is developing and obviously, that revenue is developing in line with our expectations for the quarter.

因此，我認為我們對這一趨勢的發展感到滿意，而且顯然，收入的發展符合我們對本季的預期。

Martin, do you want to take Care Enablement?

馬丁，你想參加護理支援計畫嗎？

Yes. So Veronika, you saw from the bridge we provided that business growth was a significant contributor. We also stated that overall pricing is developing in line with expectations, and globally, is it positive and contributing.

是的。所以，維羅妮卡，你從我們提供的橋樑中看到，業務成長是重要的貢獻者。我們還表示，整體定價正在按照預期發展，並且在全球範圍內是積極的和有貢獻的。

And we also see that positive momentum that you saw last year also carrying forward in the quarter. To double-click a bit on that, this includes the China effect.

我們也看到，去年看到的正面動能也在本季得以延續。進一步說，這包括中國效應。

And the China effect, as you remember, was in the second half last year, about a mid-double-digit number. And you see the annualization of the China effect now also for quarter 1, and you can also expect that for quarter 2 until we have the full cycle of the year.

大家還記得，中國效應在去年下半年顯現，大約達到了兩位數左右。現在，您會看到中國效應在第一季呈現年度化趨勢，並且您還可以預期第二季也會出現這種情況，直到我們完成全年週期。

The important thing to note is that the volume contribution that we expected is developing according to our expectations. And even including the negative China headwinds, we do see a robust solid pricing momentum in the quarter as well. And I hope that gives a bit of color.

需要注意的重要一點是，我們預期的交易量貢獻正在按照我們的預期發展。即使考慮到中國市場的不利因素，我們仍然看到本季強勁的定價動能。我希望這能帶來一些色彩。

Martin, maybe I can just push back on that a little bit or maybe ask for a little bit more detail. Obviously, you do have a large customer, which should be, I believe, paying some higher prices as of this year. Are you able to tell us how those negotiations have progressed and whether we're seeing the full impact of that already in Q1?

馬丁，也許我可以稍微推遲一下這個問題，或者要求提供更多細節。顯然，你們確實有一個大客戶，我相信從今年開始，這個客戶應該要支付更高的價格。您能否告訴我們這些談判的進展以及我們是否已經在第一季看到了其全部影響？

Veronika, I hope you understand that we do abstain from commenting on individual contracts.

維羅妮卡，我希望你理解我們不會評論個別合約。

The next question comes from Graham from UBS.

下一個問題來自瑞銀的葛拉漢。

Just one on HDF first and then on volumes and margins. In terms of how you're thinking about pitching this to competitor clinics or service providers, is it primarily the overall mortality benefit? Or is there a nuance as to which patients might benefit? And then is there actual just operational benefit in terms of lower training costs and things like that? Just to understand, as we get closer to the launch, how you're pitching that once you go commercial?

首先討論 HDF，然後討論體積和利潤。就您如何考慮向競爭對手的診所或服務提供者推銷這款產品而言，它主要體現在整體死亡率方面嗎？或者對於哪些患者可能受益是否有細微差別？那麼，在降低培訓成本等方面是否真的能帶來營運效益呢？我想了解一下，隨著發布日期的臨近，一旦產品投入商業化，您將如何推銷它？

And then on margins, we -- you've obviously had phenomenal success in the last 2 years in terms of expanding margins, but that's been effectively without any U.S. volume growth and it's kind of a rough number, but what do you think going forward when you get to a sort of normalized recovered margin, what do you think you need to grow at to sustain -- in terms of U.S. volumes to sustain that margin? When does like operating leverage kick in? Is it like 1%, 2%, do we need to get back to 3%, just to understand how that moves?

然後談到利潤率，我們——在過去的兩年裡，你們在擴大利潤率方面顯然取得了非凡的成功，但這實際上是在沒有任何美國銷量增長的情況下實現的，而且這只是一個粗略的數字，但是，當你們的利潤率恢復到某種正常水平時，您認為未來需要增長多少才能維持——就美國銷量而言，才能維持這一利潤率？經營槓桿什麼時候開始發揮作用？它是像 1% 還是 2% 呢？我們需要回到 3% 嗎，才能了解它是如何變動的？

I appreciate both of those might be a little bit early for where we are today versus Capital Markets Day, but I thought I'd try.

我知道相對於資本市場日來說，這兩個時間點可能有點早，但我想嘗試一下。

Thanks, Graham. I'll take both those. And obviously, that will be a significant part of our Capital Markets Day and kind of getting into kind of the innovation and the benefits that we see for HDF. I can click on that a little bit. And of course, the same with the margin outlook, we'll give more color there.

謝謝，格雷厄姆。我都會接受這兩個。顯然，這將是我們資本市場日的一個重要部分，並將深入探討我們所看到的 HDF 的創新和優勢。我可以稍微點擊一下。當然，對於利潤前景，我們也將提供更多說明。

But just to kind of double-click for a moment, for HDF, as I think we've been talking about this past year, we're incredibly excited about this new machine and the new -- the kind of the new treatment. A little bit of both on what you touched on, not just the mortality improvement, which if we do see that the kind of results from convinced a 23% improvement in mortality, that in itself full blown could relate to kind of 400 basis points of growth by itself, not just the patient benefit.

但是，稍微回顧一下，對於 HDF，我想我們去年一直在談論，我們對這台新機器和新療法感到非常興奮。您提到的兩方面都有所涉及，不僅僅是死亡率的改善，如果我們確實看到死亡率改善了 23%，那麼這本身就可能與 400 個基點的增長有關，而不僅僅是患者的利益。

And look, obviously, improving outcomes is a big part of what we do as the leading innovator here, but also there are operational benefits from this machine. It is much simpler to use. It doesn't need saline.

顯然，作為領先的創新者，改善結果是我們工作的很大一部分，但這台機器也能帶來營運效益。使用起來更加簡單。它不需要鹽水。

The clean downtime is quicker. No time needed between treatments and the training time is also better. So we'll go through that in a ton more detail in June, but I think we can kind of clearly see a number of treatment benefit and an operational benefit.

清潔停機時間更快。治療之間不需要間隔時間，訓練時間也更好。因此，我們將在六月更詳細地討論這個問題，但我認為我們可以清楚地看到許多治療效益和運作效益。

So I think you can see why we're excited and why we're looking for the whole industry to adopt this treatment. In terms of your second question, yes, of course, we've been driving efficiencies.

所以我想你應該明白我們為什麼這麼興奮，以及為什麼我們希望整個產業都採用這種治療方法。關於您的第二個問題，是的，當然，我們一直在提高效率。

And I think the result of the new operating model has really lent itself to the improvements that we've driven in the past 2 years. But you're right, that U.S. volume growth we've got there despite that. Obviously, we're looking to see and seeing that volume come back and that will improve operating leverage.

我認為新的營運模式確實有助於我們在過去兩年中推動的改進。但您說得對，儘管如此，美國的銷量仍然增長。顯然，我們希望看到銷量回升，這將提高經營槓桿。

Clearly, the higher utilization and obviously, we do expect to be growing above the zero and even the 0.5.

顯然，利用率更高，我們確實預期其將成長到零以上，甚至達到 0.5。

We will give more outlook on how we're seeing these market and volume trends in June as well and kind of the levers that we see both to drive top line growth and innovation as well as bottom line margin expansion.

我們將對六月的市場和銷售趨勢做出更多展望，並展望我們認為能夠推動營收成長和創新以及底線利潤率擴張的槓桿。

So we're excited, and we're excited it's only a month or so away now, but we'll clearly give more insight to the market then. And thanks for the questions, Graham.

所以我們很興奮，我們很高興現在只剩一個月左右的時間了，但我們屆時會對市場提供更多的見解。謝謝你的提問，格雷厄姆。

The next round of question comes from [Lisa from Societe Generale Bernstein].

下一輪問題來自[來自法國興業銀行伯恩斯坦的麗莎]。

Nice quarter to start the year. Two questions. Your large competitor in the U.S. has talked about significant CapEx investments over the past sort of 5-plus years, really focused on IT systems. And given that both companies were formed over a series of acquisitions, I imagine that's one area that could still be quite messy.

新年伊始，這是一個美好的季度。兩個問題。您在美國最大的競爭對手談到了過去 5 年多來大量的資本支出投資，主要集中在 IT 系統上。鑑於兩家公司都是透過一系列收購而成立的，我想這是一個可能仍然相當混亂的領域。

Just curious as to where you are on that transformation. And I think of note, DaVita has mentioned, it's been particularly useful in terms of their revenue cycle management in the private market. And so I just want to think through what the opportunities for Fresenius could be on that front? And then second, just on the HDF launch, how should we think about the ramp-up? There's obviously a long replacement cycle for machines, so should we just expect penetration of HDF to increase quite gradually despite the sort of patient benefits and as you mentioned, the operational benefits?

我只是好奇你處於這種轉變的哪個階段。值得注意的是，DaVita 提到過，它對於私人市場的收入週期管理特別有用。因此，我只是想思考費森尤斯在這方面有哪些機會？其次，就 HDF 的推出而言，我們應該如何考慮其成長？顯然，機器的更換週期很長，因此，儘管有患者獲益，並且如您提到的，還有運營獲益，我們是否應該期望 HDF 的滲透率會逐漸增加？

Just -- and lastly, just on that, what sort of manufacturing capacity will you have for serving the U.S. market? And should we worry about any potential bottlenecks there?

最後，關於這一點，您擁有什麼樣的製造能力來服務美國市場？我們是否應該擔心那裡有任何潛在的瓶頸？

Thanks, Lisa. Martin, do you want to take the first one on the capital allocation in IT, and I'll take the second?

謝謝，麗莎。馬丁，你想先回答有關 IT 資本配置的問題，然後我再回答第二個問題嗎？

Yes. Happy to, Lisa. So first of all, IT and also driving automation of our processes and efficiencies and also revenue cycle management together with EHR systems, is a focused topic of ours as well because of this being a value creation level, both on the efficiency side but also on the revenue yield. So this has been for quite some time as well. And as we continue to invest into our business, we will also here give a little bit more color on our capital allocation priorities, both how we drive profitable growth and improve profitability going forward at the Capital Markets Day as well.

是的。很高興，麗莎。因此，首先，IT 以及推動流程和效率的自動化以及與 EHR 系統一起進行的收入週期管理也是我們關注的話題，因為這是一個價值創造水平，不僅在效率方面，而且在收入收益方面。這也已經持續了相當長一段時間了。隨著我們繼續對業務進行投資，我們還將在資本市場日進一步闡述我們的資本配置重點，包括我們如何推動獲利成長以及如何提高未來的獲利能力。

But rest assured, this has been already a focus topic and will continue to be a focus topic also to invest into operational efficiencies.

但請放心，這已經是一個焦點話題，並將繼續成為投資營運效率的焦點話題。

Thanks, Martin. Lisa, the full rollout plan and how we're thinking about commercialization, both from a Care Enablement and Care Delivery, we will share at Capital Markets Day and obviously, the capital piece on that as well. Obviously, this is -- while it's exciting and unique innovation, it is also replacing an installed base. So as you can appreciate, the kind of the strategic approach here has been weighing up kind of the implementation and rollout plan versus the current installed base, but we'll give you more color into all of those questions that you had in June with quite a detailed breakout session on HDF and you can see the machine.

謝謝，馬丁。麗莎，完整的推廣計劃以及我們如何考慮商業化，包括從護理支援和護理服務兩個方面，我們將在資本市場日分享，顯然，也會分享這方面的資本部分。顯然，這是——雖然這是令人興奮和獨特的創新，但它也在取代已安裝的基礎。因此，您可以理解，這裡的戰略方法一直在權衡實施和推廣計劃與當前安裝基礎，但我們將通過 6 月份關於 HDF 的相當詳細的分組會議，為您更詳細地解答所有這些問題，您可以看到機器。

The next question comes from James from Jefferies.

下一個問題來自 Jefferies 的詹姆斯。

Just a couple please, if I may. Firstly, when we look at the operating growth of around 11% in constant currency, the EBITDA level in constant currency I think is just under 4%. So I think adjusted D&A was down materially, which is about half the margin gain. So we are at the run rate we can expect for 2025? And what are the considerations here, please?

如果可以的話，請給我一些。首先，當我們以固定匯率計算營業成長率約為 11% 時，我認為以固定匯率計算的 EBITDA 水準略低於 4%。因此我認為調整後的折舊及攤銷前利潤大幅下降，約佔利潤率成長的一半。那麼，我們的運行率是否達到了 2025 年的預期？請問這裡需要考慮哪些因素？

And then my second question is, again, just on the 5008x. You mentioned in terms of look getting preparations for launching at the end of the year. But just wondering when we might get more detail on either pricing, what sort of feedback you've got in the U.S. ahead of potential upgrades and how we should think about an upgrade cycle?

我的第二個問題同樣是關於 5008x 的。您提到了為年底推出產品做準備。但只是想知道我們什麼時候可以獲得有關定價的更多詳細信息，在潛在升級之前您在美國得到了什麼樣的反饋，以及我們應該如何考慮升級週期？

Yes. Martin, do you want to take the first one? And I'll come back to 5008x?

是的。馬丁，你想坐第一個嗎？我會回到 5008x 嗎？

Yes, more than happy to. So on the D&A, I think it's important to note that when you look at the reported numbers, there's a significant portion and element of last year's divestitures in that, which equates to most of the reduction that we saw. And hence, when you look at it in a percentage of revenue, it is not such a large extent where it comes down. It does come down a bit in the quarter. But at the same time, the maturity, which was back then over EUR100 million hit coming out of that, which we also disclosed, was driven in the depreciation and amortization by the divestitures.

是的，非常樂意。因此，關於折舊和攤銷，我認為需要注意的是，當你查看報告的數字時，其中有很大一部分是去年資產剝離的部分，這相當於我們看到的大部分減幅。因此，當你從收入百分比的角度來看時，下降的幅度並不是很大。本季確實有所下降。但同時，我們也揭露，當時到期的損失超過 1 億歐元，這是由資產剝離導致的折舊和攤提造成的。

Overall, the D&A is for us a stable development, where we do plan for, let's say, also sustainable reinvestment into predominantly our clinics as well as our machines as we place them as well next to our continued R&D investment in C&E. And also here on the capital allocation priorities for the innovation, we will give additional color also for the Capital Markets Day.

總體而言，D&A 對我們來說是一個穩定的發展，我們確實計劃對我們的診所和機器進行可持續的再投資，因為我們將它們與我們對 C&E 的持續研發投資放在一起。此外，關於創新的資本配置優先事項，我們也將為資本市場日提供額外的內容。

James, on your question about launch and probably theme of my day, more on June 17. But no, look, we are excited and the fact that we now have 11 patients, which all in one clinic getting the HDF treatment is giving us kind of real data in real time. And obviously, trying to get that proven experience in our clinics also helps with the commercialization to other players in the industry. Obviously, the pricing is kind of contract by contract and probably not going to disclose that. But I think what we are seeing and hearing as well, and we saw it in the CONVINCE study is for our patients not just the hard outcomes that we've talked about like mortality, but also their own quality of life measures and how much better they are feeling.

詹姆斯，關於你關於發布會以及我當天的主題的問題，我將在 6 月 17 日進行更多討論。但不，你看，我們很興奮，事實上我們現在有 11 名患者，他們都在同一個診所接受 HDF 治療，這為我們提供了即時的真實數據。顯然，嘗試在我們的診所獲得經過驗證的經驗也有助於向行業中的其他參與者進行商業化。顯然，定價是根據合約來決定的，而且可能不會透露。但我認為，我們所看到和聽到的，以及我們在 CONVINCE 研究中看到的，對於我們的患者來說，不僅僅是我們所談論的死亡率等硬性結果，還有他們自己的生活品質指標以及他們的感覺有多好。

It's quite -- we hope to share some of this. I think we have videos lined up, but how the patients are feeling from getting this treatment as well. So we are seeing that patients really want to be on this treatment after they're kind of seeing what's happening in the pilot. So more to come, where we're thrilled to be rolling this out. And obviously, we'll give as much detail as we can while keeping what we need to keep proprietary, proprietary if that makes sense.

這相當——我們希望分享其中的一些。我認為我們已經準備好了視頻，但患者接受這種治療後的感受如何。因此，我們發現，患者在了解了試驗結果後，確實希望接受這種治療。未來還會有更多，我們很高興能夠推出這些功能。顯然，我們會提供盡可能多的細節，同時保留我們需要保留的專有資訊（如果有意義的話）。

But yes, we look forward to seeing you next month and sharing more on that.

但是是的，我們期待下個月見到您並分享更多相關資訊。

The next caller is Oliver from ODDO BHF.

下一位來電者是來自 ODDO BHF 的 Oliver。

First one is about a deeper view on the same market treatment growth in the U.S. So the peak of flu season was early to mid-February. So the 6-week cycle should have come to end somewhere in April. So have you seen an excessive mortality or was the negative impact more about that the patients stayed longer in hospitals and were consequently not available for treatments in your clinics? The second one is on the current foreign exchange environment.

第一個是關於美國同一市場治療成長的更深入的看法。因此，流感季節的高峰期是二月初至二月中旬。因此，六週的周期應該在四月的某個時候結束。那麼，您是否看到了過高的死亡率，或者負面影響是否更多的是患者在醫院停留的時間更長，因此無法在您的診所接受治療？第二個是關於目前的外匯環境。

Can you give us your view if the euro-U.S. dollar remains at the level as it stands right now what will be the impact on top and bottom line?

您能否談談對歐元和美元的看法？美元維持在目前的水準會對營收和利潤產生什麼影響？

Sorry, I was on mute here. Oliver, I'll take the first one on same market treatment growth. Yes, look, we did see the numbers in the February, the spike. We started to see it come down in March. We haven't -- we're still getting data in real time.

抱歉，我剛才靜音了。奧利佛，我將首先討論同市場治療成長。是的，你看，我們確實看到了二月的數字激增。我們從三月開始看到它下降。我們沒有——我們仍在即時獲取數據。

I'd say too soon to say that anything has changed. We're still seeing that slightly elevated mortality. What the full impact was from the flu season, I don't think we'll start to see that until May. So obviously, when we get to Q2, we'll be able to see how that trend is continuing. But yes, too soon for us to tell at this point.

我認為現在說任何事都發生了改變還為時過早。我們仍然看到死亡率略有上升。我認為我們要到五月才能看到流感季節的全部影響。因此顯然，當我們進入第二季度時，我們將能夠看到這種趨勢如何持續。但是，是的，現在我們下結論還為時過早。

What we saw in Q1, obviously, was still elevated, but the flu data with the 6- to 8-week lag will be later. Martin, do you want to take the FX.

顯然，我們在第一季看到的數據仍然偏高，但滯後 6 至 8 週的流感數據將會更晚。馬丁，你想搭乘 FX 嗎？

Yes. Oliver, on the FX, I mean, obviously, in the current environment, it's very hard to predict where the U.S. dollar will go with the volatility that we see. At the same time, let me give you some color, how we think about it and how we also here specifically on the translation topic that it is for us, have started the year and see the rest of the year. In the quarter 1, for us, the average rate was about at 105.

是的。奧利佛，關於外匯，我的意思是，顯然，在當前環境下，我們很難預測美元在我們看到的波動下會走向何方。同時，讓我告訴你們我們對此的看法，以及我們如何在這裡具體討論翻譯主題，如何開始新的一年並展望今年的剩餘時間。在第一季度，我們的平均利率約為 105。

And you also saw that in quarter 1, we had a positive FX tailwind to the results. At the same time, we ended the quarter at a spot rate of 108, which is pretty much in line with the indication that we gave to you for the outlook when we shared our assumptions for 2025 results.

您還看到，在第一季度，我們的業績受到了外匯方面的積極推動。同時，本季結束時的現貨匯率為 108，這與我們在分享 2025 年業績假設時給出的前景預測基本一致。

And I think currently, when you look at it today, in the last couple of days, we are hovering around the 113-ish. And when you would expect that we stay at a similar level, that would, for us, mean about a 2% to 3% headwind on the top and bottom line for the full fiscal year 2025. And I hope that helps a bit of color.

我認為目前，當你今天看過去幾天的情況時，我們徘徊在 113 左右。當您預期我們保持在類似水平時，對我們來說，這意味著 2025 財年全年的營收和利潤將面臨 2% 至 3% 的阻力。我希望這能為色彩帶來一些幫助。

The next question comes from Hugo from BNP.

下一個問題來自法國國家黨的 Hugo。

I have 3 questions, please. First on tariffs. I know probably not very material for you, but could you help us understand a bit more what the impact could be, should things change at the beginning of July? Second, a follow-up on Lisa's question. Your U.S.

我有 3 個問題，請問。首先是關稅。我知道這對您來說可能不是很重要，但是如果 7 月初情況發生變化，您能否幫助我們更多地了解可能產生的影響？第二，跟進一下麗莎的問題。您的美國

competitor also suffered a severe attack earlier in April. Just wondering if you could comment on anything you've seen that would impact you positively more patient or increasing recourse, for example, keen to get your thoughts on that? And lastly, on volumes. If I'm not mistaken, you mentioned 40 bps tailwind on U.S. volumes from referral in Q1 Or should we think about this accelerating potentially throughout the year?

競爭對手在四月初也遭受了嚴重的攻擊。只是想知道您是否可以評論一下您所看到的會對您產生積極影響的任何事情，例如，讓您更有耐心或增加追索權，例如，渴望聽聽您對此的看法？最後，關於數量。如果我沒記錯的話，您提到第一季美國交易量因推薦而出現了 40 個基點的順風，或者我們是否應該認為這種順風在全年都有可能加速？

Thanks, Hugo. I think I can -- I'll tag all of those. First, on tariffs. As you heard and we sort of outlined, no impact in Q1 and we're calling it somewhat limited for full year. For the U.S.

謝謝，雨果。我想我可以——我會標記所有這些。第一，關於關稅。正如您所聽到的，我們也概述了，第一季沒有影響，我們認為全年的影響比較有限。對美國來說

footprint, we have a lot of U.S. local manufacturing. So all the consumables are kind of produced in the U.S. We do have machines coming in from Germany and/or final assembled in Mexico. I think as a result of all that we've done with FME25 and kind of rebuilt our manufacturing footprint and supply chain, we're pretty, pretty resilient here.

足跡，我們有許多美國本地製造業。因此，所有消耗品都是在美國生產的。我們確實有從德國進口的機器和/或最終在墨西哥組裝的機器。我認為，由於我們在 FME25 上所做的一切以及重建我們的製造足跡和供應鏈，我們在這裡相當有彈性。

So we see the impact is limited clearly with the USMCA agreements as well as other protocols that are in place. We feel pretty good about what we are seeing. Look, I think the broader question is what does this do ultimately to kind of inflation or labor rates.

因此，我們看到，USMCA 協議以及其他現行協議的影響顯然是有限的。我們對所見所聞感到非常滿意。我認為更廣泛的問題是這最終會對通貨膨脹或勞動率產生什麼影響。

And obviously, we would be looking to see what we would need to pass on in pricing, but at this point from what we can see through 2025, we're feeling pretty good and as you can appreciate, a lot of work being done on the flows of materials and the relative impact in scenarios. So a special call out to the tariff task force for the great work that they've done here.

顯然，我們會關注需要在定價方面傳遞什麼，但從目前我們對 2025 年的展望來看，我們感覺非常好，而且正如您所看到的，我們在材料流動和情景中的相對影響方面做了大量工作。因此，我要特別讚揚關稅工作小組在這裡所做的出色工作。

Your second question regarding the cyber-attack on DaVita and what we are seeing. Clearly, I'm not going to comment on kind of how -- what impact that's had there for them. But we have seen, during the quarter, some -- in Q2, I should say, not Q1, some benefit from additional patient referrals.

您的第二個問題是關於針對 DaVita 的網路攻擊以及我們所看到的情況。顯然，我不會評論這對他們產生了什麼影響。但我們在本季看到，我應該說是第二季度，而不是第一季度，有些人從額外的患者轉診中受益。

What that translates into, we'll see when we close April. But obviously, our priority is making sure that patients get the care they need.

這意味著什麼，我們將在四月底看到結果。但顯然，我們的首要任務是確保患者得到所需的照護。

And I think the work that we've done on accelerating and improving our admissions process and patient inflows is clearly working in our favor. Your third point on the 40 bps impact, that was from a negative missed treatment, not from inflow.

我認為，我們在加速和改善入院流程和病患流入方面所做的工作顯然對我們有利。您的第三點是關於 40 個基點的影響，這是由於負面錯過治療，而不是流入。

What we're saying is the accelerated inflow has neutralized, the missed treatment impact, that was mainly due to flu. So we're flat with a 40 bp headwind, if you will, from flu, which is also supported by the underlying inflow that we are seeing.

我們所說的是，加速流入已經抵消了主要由於流感而導致的錯過治療的影響。因此，如果您願意的話，流感給我們帶來了 40 個基點的不利影響，而我們看到的潛在流入也支持了這一點。

And the next question comes from Marianne from Bank of America.

下一個問題來自美國銀行的瑪麗安。

The first one is, could you talk a little bit about the remaining FME25 savings that you expect for the rest of this year? I've noticed that you have already delivered a large chunk into Q1. So just wondering a little bit where do you see the most of the remaining savings coming from? And what do you need to deliver them?

第一個問題是，您能否談談您預計今年剩餘時間內剩餘的 FME25 節省金額？我注意到您已經在第一季度交付了很大一部分成果。所以我只是有點好奇，您認為剩餘的大部分儲蓄來自哪裡？您需要送什麼東西給他們呢？

And then a bit more of a broader question on the company, and I appreciate that might be further discussed at the CMD, but as you look into your portfolio, have you identified or are you still working on identifying other assets that aren't growing as profitably as you would like and that you could potentially sell over the midterm?

然後是關於公司的一個更廣泛的問題，我知道這個問題可能會在 CMD 上進一步討論，但是當您研究您的投資組合時，您是否已經確定或者仍在努力確定其他沒有像您希望的那樣盈利增長的資產，並且您可能在中期出售這些資產？

Thanks, Marianne. Martin, you want to take the FME25, and I'll take the divestiture question?

謝謝，瑪麗安。馬丁，你想參加 FME25 會議，然後我來回答剝離問題？

Yes. More than happy to. Marianne, as you saw in the quarter, we had a good quarter contribution and also with the EUR68 million and the total year of EUR180 million, we feel that we started well. The phasing of that was in line with our expectations.

是的。非常樂意。瑪麗安，正如您在本季度看到的，我們取得了良好的季度貢獻，並且憑藉 6800 萬歐元和全年 1.8 億歐元的貢獻，我們覺得我們的開局很好。此階段的實施符合我們的預期。

And also when we give additional color on that, you do see further contributions from the Care Enablement, also from the manufacturing and supply chain footprint optimization that we have, but also some further contributions from the G&A functions as well as CD to a smaller extent.

而且，當我們對此進行進一步闡述時，您確實會看到來自護理支援、來自我們擁有的製造和供應鏈足跡優化的進一步貢獻，以及來自 G&A 功能以及 CD 的一些較小程度的進一步貢獻。

We continue to see that structure also holding through the remainder of the year, and the overall phasing, as I said, is in line with our expectations and should give us good confidence or gives us good confidence for the fiscal year target.

我們繼續看到這種結構也將持續到今年剩餘時間，正如我所說，整體分階段符合我們的預期，應該會讓我們對財政年度目標充滿信心。

Yes. Regarding your question on divestiture, so really, really pleased and proud of the progress the teams have made over the last 2 years in cleaning up the portfolio. As you would have seen in the Q1, we've already announced it at full year, the Spectra Labs in Malaysia are kind of the 2 in the quarter.

是的。關於您關於資產剝離的問題，我真的非常高興和自豪團隊在過去兩年裡在清理投資組合方面取得的進展。正如您在第一季所看到的，我們已經宣布了全年業績，馬來西亞的 Spectra Labs 在本季度排名第二。

I'd say, for the most part, we're done -- I mean, we obviously, as part of our ongoing review of our country portfolio, we'll look to make sure that there's nothing that's changing in the environment that would change our view on any small market, but I feel good about where we are and that's part of our new rigor and discipline that we will continue to look at the performance of the assets to make sure they're performing as they need to.

我想說，在很大程度上，我們已經完成了——我的意思是，顯然，作為我們對國家投資組合持續審查的一部分，我們將確保環境中沒有任何變化會改變我們對任何小市場的看法，但我對我們所處的位置感到滿意，這是我們新的嚴謹和紀律的一部分，我們將繼續關注資產的表現，以確保它們按需要表現。

I think we're very clear of what is core and the work that we need to do to continue to drive the improvement in the core.

我認為我們非常清楚什麼是核心，以及我們需要做什麼工作來繼續推動核心的改進。

And again, I think you can kind of see how streamlined that has now become compared to where we were 2 years ago, again, we can share more on that in June.

再次，我想你可以看到與兩年前相比，現在的情況變得多麼精簡，我們可以在 6 月分享更多相關資訊。

The next question comes from Richard from Goldman Sachs.

下一個問題來自高盛的理查。

Just 2 for me, please. The first one is a follow-up on the treatment volume dynamics and the strong referrals you mentioned. Could you just tell us where we are on the growth of new starts today and how that compares to this time last year? That's the first question.

給我 2 個就好。第一個是對您提到的治療量動態和強烈推薦的跟進。您能否告訴我們目前新開工的成長情況以及與去年同期相比如何？這是第一個問題。

And then the second one, it's been a while now, but could you just comment if you've seen any changes in the competitive dynamic or potential opportunities that have been created by Baxter sale of Vantive to Carlyle?

然後是第二個問題，現在已經有一段時間了，但是您能否評論一下，您是否看到 Baxter 將 Vantive 出售給 Carlyle 後競爭動態或潛在機會發生了任何變化？

I don't know if I have that treatment volume year-over-year. Let me see if we can snag that as we're talking here. Martin or Dominik, I think you can pull that for me here. In terms of the competitive dynamic, obviously, we both participate in different parts of the -- whether it be of the whole market, whether it be PD or HHD, we're happy -- we're always happy to have the competition. And I think the focus lens that Vantive is bringing is good for the overall market.

我不知道我每年的治療量是否都如此。讓我看看我們在這裡談話時是否能解決這個問題。馬丁或多明尼克，我想你們可以幫我實現這一點。就競爭動態而言，顯然我們都參與了整個市場的不同部分，無論是 PD 還是 HHD，我們都很高興——我們總是很高興有競爭。我認為 Vantive 帶來的聚焦鏡頭對整個市場有利。

We feel very proud of the work that we are doing. And I think the progress that we are seeing in terms of volume growth across all regions, pricing acceleration and margin expansion really speaks to the kind of how we see our own product assets and the work that we're doing.

我們對自己所做的工作感到非常自豪。我認為，我們在所有地區的銷售成長、定價加速和利潤率擴大方面所看到的進展確實反映了我們如何看待自己的產品資產和我們正在做的工作。

So we are obviously significant market share in HHD. We're clearly #2 in PD, but we think that there's space for both companies to compete and operate. And we're very clear of what the potential is and what we can do.

因此我們在 HHD 中顯然佔有相當大的市場份額。我們在 PD 領域顯然排名第二，但我們認為兩家公司都有競爭和營運的空間。我們非常清楚我們的潛力是什麼以及我們能做什麼。

So yes, it's focused on what's in our control and how we continue to drive this business and the progress, I think, speaks for itself there. Thank you, guys are calling the same market treatment growth. I think on the referrals, on the phasing, what we are seeing is that it has improved every month, but year-over-year the referrals are down. I think the challenge we have in Q1 is there's one less dialysis day.

所以是的，它專注於我們能控制的事情以及我們如何繼續推動這項業務，我認為，進展是不言而喻的。謝謝你們，大家正在談論同樣的市場治療成長。我認為，就推薦數量和分階段而言，我們看到的是，它每個月都在改善，但與去年同期相比，推薦數量卻在下降。我認為我們在第一季面臨的挑戰是透析日減少了一天。

And so that's one day less for accepting new patients, but we are -- we're very pleased with the progress we are making.

因此接收新病人的時間減少了一天，但我們對所取得的進展感到非常滿意。

And I think the other piece that we are seeing here clearly on the admissions and the work that we've been doing on getting new patients and getting them admitted and keeping them in the clinics, is obviously the operational turnaround taking hold here. So I kind of think the leading indicators are going in the right direction.

我認為，我們在接收新病人、讓他們入院並讓他們留在診所方面所做的工作清楚地表明，這裡的運作狀況正在好轉。所以我認為領先指標正朝著正確的方向發展。

The next question comes from David from JPMorgan.

下一個問題來自摩根大通的戴維。

Most have been asked already, but maybe I could just push you a little bit more on the phosphate binders in the quarter, if you could clarify that double-digit, that's quite a wide range, how much you saw in Q1? And just to confirm, are you happy with that EUR50 million to EUR100 million still?

大多數人已經被問過了，但也許我可以再向您強調一下本季度磷酸鹽結合劑的情況，如果您能澄清一下這個兩位數，那是一個相當大的範圍，您在第一季度看到了多少？只是想確認一下，您對那 5,000 萬到 1 億歐元還滿意嗎？

And I suppose just on that, obviously, the EUR12 million improvement in Care Delivery EBIT, basically, did that all come from phosphate binders, just a follow-up there? And then secondly is a wider one. Are you seeing anything in the new U.S.

我想就這一點而言，顯然，護理服務息稅前利潤增加了 1200 萬歐元，基本上，這是否全部來自磷酸鹽結合劑，這只是後續行動？其次是更廣泛的。你在新的美國看到了什麼嗎？

administration on the Medicare side or on the regulatory side that is concerning?

醫療保險管理方面還是監管方面的問題令人擔憂？

Martin, sorry, do you want to take binders, and I'll take the administration?

馬丁，對不起，你想拿活頁夾，我來負責管理嗎？

Yes, I'll take the binder one. So to also reiterate a bit, we did give an indication of an effect for the full year of about EUR100 million. And also, I did say that for quarter 1, we have always anticipated quarter 1 to be a bit stronger contribution because of how the mechanics work and also starting out with a higher ASP assumption and then having ASPs being reduced throughout the year consistently.

是的，我要那個活頁夾。因此，再次重申一下，我們確實預計全年的影響約為 1 億歐元。而且，我確實說過，對於第一季度，我們一直預計第一季度的貢獻會更強勁一些，因為機制的運作方式以及從較高的 ASP 假設開始，然後全年 ASP 持續降低。

So also here, we have seen a double-digit contribution or double-digit million contribution in the quarter, as we called out on the profitability side. And this is across all assets in our portfolio.

因此，正如我們在盈利方面所說的那樣，我們在本季度也看到了兩位數的貢獻或兩位數的百萬的貢獻。這涵蓋了我們投資組合中的所有資產。

We have given the color that it is more a positive on the pharma and clinics business and the negative on the pharmacy business. So I hope that additional color helps.

我們認為這對製藥和診所業務更有利，對藥房業務更為不利。所以我希望額外的顏色能有所幫助。

Yes, David, your question on the new administration. Obviously, we're all navigating all those changes. The color that we've got to date is not expecting to see changes on the base kind of Medicaid or Medicare programs or the participation in kidney care or anything changing.

是的，大衛，你的問題是關於新政府的。顯然，我們都在適應所有這些變化。到目前為止，我們預計基本醫療補助或醫療保險計劃、腎臟護理參與度或任何其他方面不會改變。

Obviously, we have seen some targeted cuts in other parts of health care, but what we are seeing in our core business looks fine. I mean there were some early changes of models.

顯然，我們看到醫療保健其他領域的一些有針對性的削減，但我們的核心業務看起來還不錯。我的意思是早期的模型有一些變化。

There was the tangible change of the ETC models that were ending by the end of 2025, that was a mandatory model. Actually, that worked out quite well for us or minimal impact. So that's all we have seen and heard, but of course, the conversations and the kind of just the relationships building and continuing in D.C.

ETC 模型有一個明顯的變化，即到 2025 年底將終止使用，這是一個強制性模型。實際上，這對我們來說效果很好或影響很小。這就是我們所看到和聽到的一切，當然，還有在華盛頓建立和延續的對話和關係。

But a lot of our input says that those big changes that the President has said the scope seems to be off the table, which is -- but obviously, we continue to monitor.

但是，我們的許多意見都表明，總統所說的那些重大變化似乎不在考慮範圍內，但顯然，我們會繼續關注。

The next question comes from Robert from Morgan Stanley.

下一個問題來自摩根士丹利的羅伯特。

Just a couple left. One was just on the equipment business and the margin profile through the year. How should we think about that? You've seen 2 or 3 quarters now where that margin has been building quite nicely. Is there any seasonality at all in that business that we should think of heading through the year?

只剩下幾個了。其中一個是關於設備業務和全年利潤狀況。我們該如何看待這個問題？您現在已經看到 2 到 3 個季度以來利潤率一直在穩步提升。我們應該考慮全年的這個行業是否有季節性？

Or is that we just assume that 1Q is a sort of base level and it's upwards from here? And then the only other one I had left was just around return on capital employed.

或者我們只是假設 1Q 是一種基準水平，並且從這裡開始向上？然後我剩下的唯一問題是資本使用報酬率。

I saw you put in a slide on that towards the back of the pack, just thinking about some of the key elements that are driving that ROCE back up into the high single-digit territory where you were maybe 7 or 8 years ago, what are the key elements do you think in terms of getting there from where you are today? Is it just the operational leverage of the business as the growth comes back? Or are there other elements as well?

我看到您在幻燈片的最後部分放了一張關於這個的幻燈片，只是在思考一些關鍵因素，這些因素推動 ROCE 回到 7 或 8 年前的高個位數水平，您認為從現在的水平達到這個水平的關鍵因素是什麼？這是否只是業務恢復成長時的營運槓桿？或是有其他因素嗎？

Thanks, Robert. I'll take the first one, and Martin can take the second one. Yes, look, we don't guide by segment within the year, but we've made it very clear that for our Care Enablement business, we have a margin band of 8 to 12.

謝謝，羅伯特。我會選第一個，馬丁可以選第二個。是的，你看，我們不會按年度內的各個細分市場進行指導，但我們已經非常明確地表示，對於我們的護理支援業務，我們的利潤率區間為 8 到 12。

And in Q4, it's typically the strongest. So starting Q1 at 8.3, I think you can expect that target, we continue to improve that margin band kind of along the way this year.

而在第四季度，它的表現通常最為強勁。因此，從第一季的 8.3 開始，我想您可以預期這個目標，我們今年將繼續提高這一利潤率。

What I'm excited to show is where we go from here and where we see this med tech margin in the future. But obviously, that will be June. But I think the progression for this business over the year. And we always said, look, we were starting from a 2% margin here. And I always said, we have very definitive plans all underpinned with initiatives.

我很高興向大家展示我們未來的發展方向以及未來醫療技術利潤的前景。但顯然，那將是六月。但我認為這項業務在過去一年中取得了進展。我們總是說，看，我們的起點是 2% 的利潤率。我總是說，我們有非常明確的計劃，並且所有計劃都以舉措為基礎。

It would be back-end loaded, and that's what we're seeing, but the acceleration that we're seeing is a great testament to the Care Enablement team and all that they're delivering, both on FME25, but also on volume and kind of market share as well as pricing.

它將是後端加載的，這就是我們所看到的，但我們所看到的加速很好地證明了 Care Enablement 團隊以及他們在 FME25 上所做的一切，以及在數量和市場份額以及定價方面。

So across the board, I feel that we are kind of pulling on every cylinder there. So look forward to kind of showing the outlook for this beyond 2025.

所以從整體來看，我覺得我們正在竭盡全力。因此期待展示 2025 年以後的前景。

So let me take the capital efficiency one. And thank you, Robert, for the question. So you have seen a nice recovery from our low in the 2023. And to your point, yes, this is partially on the back of the operational transformation and turnaround and the improvement of the profitability.

那麼讓我來談談資本效率。謝謝羅伯特提出的問題。因此，您已經看到我們從 2023 年的低點開始強勁復甦。是的，正如您所說，這在一定程度上得益於營運轉型和扭虧為盈以及盈利能力的提高。

And you can expect us to further drive profitable growth in that regard.

您可以期待我們在這方面進一步推動獲利成長。

So yes, a major part comes from the operational performance improvement. The second piece actually is a continued stringent capital management. And yes, we do see still potential and continue to manage that capital efficiency piece also on the capital side.

是的，很大一部分來自於營運績效的提升。第二點其實就是持續嚴格的資本管理。是的，我們確實看到了潛力，並將繼續在資本方面管理資本效率。

And when you saw the trajectory where we improved over 8 percentage points compared with 2023 that we have seen in Q1, I think you also see that those measures are taking effect, and we will continue to focus on further improving it. We are not happy with where we stand.

當您看到我們在第一季看到的與 2023 年相比提高了 8 個百分點以上的軌跡時，我想您也會看到這些措施正在發揮作用，我們將繼續致力於進一步改善它。我們對目前的情況並不滿意。

We have been very clear that we want to further improve and drive it also above the mid-single-digit margin ROIC levels as well.

我們已經非常明確地表示，我們希望進一步改善並推動其達到中等個位數的 ROIC 利潤率水準。

The next question comes from Falko from Deutsche Bank.

下一個問題來自德意志銀行的 Falko。

Just a few quick ones. Firstly, on the improving referral process that you mentioned, that's good to hear. How far away is that still from where you would want to see it ultimately? And second question on cost cutting. Obviously, you've done a tremendous job over the recent past on that front.

僅舉幾個例子。首先，關於您提到的改進推薦流程，我很高興聽到這個消息。這距離您最終希望看到的目標還有多遠？第二個問題是關於削減成本。顯然，您最近在這方面做出了巨大的貢獻。

How much of a topic will that still be beyond this year? I know you're going to speak about that at the CMD, but maybe you can give us some initial flavor. I mean the house is still standing, you've taken a lot of cost out. Is there still a lot more to go? You've just had divestments, you're sort of done with that.

今年以後這還會成為多大的話題？我知道您將在 CMD 上談論這個問題，但也許您可以給我們一些初步的介紹。我的意思是房子還在，你已經省了很多成本。還有很多事情要做嗎？你剛剛進行了資產剝離，這件事情算是結束了。

So on the pure cost cutting, what's to be expected beyond 2025? And then last but not least, on share buybacks, it seems to be some excitement in the market that you might be announcing something big in terms of share buyback plans at the CMD. Is there anything you can say about that at this point, how you're looking at these, whether that's something you would at all consider going forward?

那麼，從純粹的成本削減角度來看，2025 年以後會有什麼預期呢？最後但同樣重要的一點是，關於股票回購，市場似乎有些興奮，因為您可能會在 CMD 上宣布一些重大的股票回購計劃。您現在對此有什麼看法嗎？您如何看待這些？您是否會考慮繼續推進這項工作？

Falko, you made me smile, and yet my house is still standing, but we'll tag team these questions. Look, in terms of the improving referral process, I mean when we are all back to a 3% plus growth rate, and we're seeing all the patient funnel from CKD refill and we're snagging every patient that we can from any physician that is referring someone to us.

法爾科，你讓我笑了，儘管我的房子還在，但我們會一起回答這些問題。你看，就改進轉診流程而言，我的意思是當我們都回到 3% 以上的增長率時，我們會看到所有來自 CKD 補充的患者管道，我們會從任何向我們轉診的醫生那裡搶佔每一位患者。

But I think then we get to a point where we're happy, right? But until then, we'll continue to work and make sure our processes and the patient flows are getting momentum along that way. And I feel like that's where we are finally starting to see that proverbial light where our internal processes are significantly improved.

但我想我們會達到一個快樂的境界，對吧？但在此之前，我們將繼續努力，確保我們的流程和患者流量能夠順利發展。我覺得我們終於開始看到所謂的曙光，我們的內部流程得到了顯著改善。

The flows are improving, but more importantly, that the CKD funnel that has been a bit of an uncertainty to us through this COVID period or post-COVID period, seeing that improvement is key. We're obviously taking it a quarter at a time on what we can do there.

流程正在改善，但更重要的是，CKD 漏斗在整個 COVID 時期或後 COVID 時期對我們來說有點不確定，看到改善是關鍵。顯然，我們每次只花四分之一的時間來考慮我們能在那裡做些什麼。

In terms of the cost cutting, yes, look, I feel incredibly proud of what we've all accomplished on FME25, not just cost-cutting, but really kind of streamlining the organization around the operating model or the new operating model and driving efficiencies. I think for us, where we see further opportunities to drive improvements and to invest in the company, we will take a look at those.

在削減成本方面，是的，看，我對我們在 FME25 上所取得的成就感到無比自豪，不僅僅是削減成本，而且真正圍繞運營模式或新運營模式精簡了組織並提高了效率。我認為，對我們來說，如果我們看到進一步推動改進和投資公司的機會，我們就會考慮這些機會。

And I think that would obviously be part of our outlook for June.

我認為這顯然會成為我們六月展望的一部分。

And capital allocation, I know that's a big ask from everyone. A bit of a repeat answer, I'm sorry. More to come in June on what we plan to do with that capital and how we deploy it to shareholders. At the end of the day, you know we're focused on value creation, and we'll give you insights into how we're thinking about that.

至於資本配置，我知道這對每個人來說都是一個很大的要求。答案有點重複，抱歉。我們將在六月公佈更多關於我們計劃如何使用這些資金以及如何將其分配給股東的資訊。歸根結底，您知道我們專注於創造價值，我們將向您介紹我們對此的看法。

So thank you, everyone. That's the first in 15 years of IR, we have 4 minutes left and no questions. So that is great. We answered all questions. That's good.

謝謝大家。這是 IR 15 年來的第一次，我們還剩下 4 分鐘，沒有問題。這太棒了。我們回答了所有問題。那挺好的。

Thank you very much for listening in to our call. We will go now very quiet until our Capital Markets Day for obvious reasons because the questions you will get answered at the Capital Markets Day. And we look forward to seeing you all. Please register, if you haven't, and we'll see you in London on June 17, I hope.

非常感謝您收聽我們的電話。出於顯而易見的原因，我們現在將非常安靜，直到資本市場日，因為你們的問題將在資本市場日得到解答。我們期待與大家見面。如果您還沒有註冊，請立即註冊，希望我們能在 6 月 17 日在倫敦與您會面。

Yes. Thanks, everyone. Look forward to seeing you in June. Take care. Bye-bye.

是的。謝謝大家。期待六月與您相見。小心。再見。

Thank you. Take care. Bye-bye.

謝謝。小心。再見。