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Climate change and its effects are also impacting Fresenius: in healthcare facilities we have to prepare for rising temperatures and the increase in severe weather events in order to continue to protect the health of patients.

Another current challenge: Energy is becoming more and more expensive, especially if it is obtained from dwindling fossil resources. Energy efficiency is therefore an increasingly important factor for Fresenius. Our production processes and the operation of healthcare facilities require a high level of energy input. Energy-efficiency measures can lead to short- and long-term cost savings. In addition, through the increased usage of renewable energies, they also make an important contribution to climate protection.

Our approach

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In energy management and climate protection, our aim is to go beyond the legal framework to identify ways of minimizing the impact on the environment and to implement these in our management approaches. In 2022, the business segments focused primarily on the topics of energy saving, purchasing green electricity, and thus the reduction of CO2 emissions.

Uninterrupted energy supply is a top priority for Fresenius in order to ensure patient safety and reliable production or care. Within this context, we implement energy-saving measures wherever possible. Details for each business segment can be found in the following sections.

The energy management system is geared to the requirements of our business segments and is certified according to ISO 50001. We are constantly expanding the number of certified sites.

Fresenius further invests in new buildings and modernizations that meet the latest energy standards and legal requirements.

Fresenius Medical Care

The business segment is committed to developing measures to reduce energy consumption and GHG emissions across its business. Energy efficiency and climate protection are integral aspects of the global environmental strategy.

Further information on the management approach can be found in the Environmental management section.

Progress and measures in 2022

In 2022, Fresenius Medical Care defined global climate targets. The business segment plans to be climate neutral by 2040. By 2030, it aims to reduce Scope 1 (direct) and Scope 2 (indirect) emissions by 50% compared with the reported emissions scope of the base year 2020.

In the reporting year, a project team was set up to drive the implementation of the climate roadmap. To achieve the targets, the business segment currently focuses on renewable energy sourcing, which includes the purchase of renewable energy certificates, and energy efficiency measures. Moving forward, Fresenius Medical Care also intends to evaluate other measures for reducing emissions such as process optimization, renewable energy generation, and technology assessments.

In 2022, Fresenius Medical Care enhanced the reporting processes for indirect greenhouse gas emissions to additionally include market-based emissions, which are calculated using residual mix factors. The location-based emissions that the business segment disclosed in past reporting take into account the average emission factors for the electrical grids that power its operations. The market-based approach reflects energy generated as part of contractual arrangements such as the purchase of renewable energy. Adding market-based emissions to the reporting will enable the business segment to demonstrate its emission reduction activities more transparently going forward.

Fresenius Kabi

The focus of the energy management system at Fresenius Kabi is on improving energy performance and preventing excessive use of energy. Key opportunities are reducing energy and emissions in proportion to the volume of production activities. Fresenius Kabi derives its energy mainly from external providers. This includes the purchase of renewable energy such as hydropower, solar, or wind power. The business segment also generates electricity in its own facilities and uses, e. g., combined heat and power systems or solar panels at its own sites. The business segment has put into operation further solar panels in 2022 and wants to increase the share of renewable energy in its overall energy consumption.

Local measurable objectives and energy targets are derived from the business segment’s global energy policy. As stated in the Environmental management section, Fresenius Kabi has matrix certification for its global energy management system, which is audited annually and certified by TÜV Rheinland.

Responsibility for energy management is anchored in the management board areas and local organizations; global management responsibility lies with the central EHS function, which reports to the responsible member of Fresenius Kabi’s Management Board.

Progress and measures in 2022

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In 2022, the management approach and governance structure of Fresenius Kabi remained as reported in 2021. Progress focused on increasing energy efficiency and reducing CO2 emissions in proportion to the volume of its production activities.

Several ideas were submitted for energy as part of the GCC’s 2022 campaign to raise awareness for environmental management and generate approaches to improve water and energy management at its sites. The manufacturing plant in Kalyani, India, proposed to use waste from Taxus Baccata leaves, which is needed to extract an ingredient for the products manufactured at the site, and convert it into biogas. Up to 120-190 kg biogas can be produced per day and used as cooking gas in the cafeteria, as boiler fuel or the mineral residues left over from production as biofertilizer in the garden. Another example stems from the manufacturing plant in Linz, Austria, which focuses on optimizing agitators for crystallization in the production. The production plant in Haina, Dominican Republic suggested to use automatic compressed air and light control leading to an increase in energy efficiency.

Moreover, several energy saving measures have been implemented in 2022 such as installation of LEDs saving about 645 MWh, replacement of heating, ventilation and air conditioning (HVAC) system saving about 300 MWh of energy.

Furthermore, Fresenius Kabi has taken further steps to use energy from solar power. Thus, the business segment, for example, has put into operation solar panels at its sites in Guangzhou in China, Haina in the Dominican Republic and San German in Puerto Rico in 2022. The recently installed solar panels have a capacity of about 4,883,000 KWh per year. The energy will be used in the production of Fresenius Kabi’s MedTech products. The business segment is working on extending the number of solar panels at its own sites in the future.

Fresenius Helios

The rising temperatures resulting from climate change are also affecting Fresenius Helios’ business operations, especially in Spain. In recent years, refrigeration technology, which serves to cool technical equipment and hospital rooms, has become more important for hospital operations than heat generation. In addition, more frequent severe weather events such as heavy rainfall or flooding may pose a threat to the smooth healthcare services of hospitals.

In addition, further impacts of climate change on human health are likely: changes such as vector-borne infectious diseases (e. g., by mosquitoes, which are spreading into new areas as a result of climate change) can, for instance, influence the range of treatments offered by the facilities. The likelihood of pandemic outbreaks due to zoonotic diseasesZoonotic diseasesInfectious ​diseases ​that ​occur ​equally ​in ​animals ​and ​humans ​and ​can ​be ​transmitted ​both ​from ​animals ​to ​humans ​and ​from ​humans ​to ​animals. will triple in the coming decades, and according to calculations by the Lancet Countdown (2018), 30,000 additional heat-related deaths are expected in the European Union by 2030.

In Germany, the Infrastructure business unit has established a central energy procurement and management system that records the energy consumption of each site. Helios Germany uses this system to compare consumption figures and to initiate improvement measures. Helios Germany’s own energy supplier, HKG Energiedienstleistungen GmbH, is responsible for energy procurement.

Various parameters can be monitored via a central portal – from the price of electricity on the energy market to the hospitals’ respective energy consumption. In order to monitor energy flows more precisely, a measurement concept is being implemented at relevant sites. This is an essential component to meet the requirements of the ISO 50001 standard. With its central energy procurement and management system, Fresenius Helios can compare the consumption values of the clinics, initiate targeted improvement measures, and share best practices from individual clinics within the company.

Helios Germany covers a low double-digit percentage of total electricity consumption with self-generated electricity. This contributes to a secure and uninterrupted energy supply for the clinics. As a result, Helios saves CO2 emissions at the German clinic sites compared to complete external procurement.

In order to ensure an uninterrupted energy supply at all times, every hospital of Helios Germany and Helios Spain has a mains backup system: in the event of a power outage, this system guarantees a secure supply of electricity for the principal energy consumers in the clinics within a few seconds. To safeguard this protection, these emergency power systems are inspected and tested regularly – monthly in Germany and at least once a year in Spain.

Helios Spain analyzes its energy management risks annually, and in some hospitals the division uses renewable energy sources. Electricity and natural gas are purchased centrally at Helios Spain. The energy manager, who monitors the consumption of all hospitals and provides corresponding data for evaluation and comparative analyses. In addition, each hospital reviews and implements specific energy-saving measures. Seven Helios Spain hospitals use thermal solar energy and photovoltaic systems to generate energy. To generate thermal energy, the division also uses miniature combined heat and power plants at two hospitals and a biomass boiler at another hospital.

Fertility Services has a central department in Spain to monitor energy consumption in all Spanish clinics. At the headquarter, a total of 54 solar panels with a production capacity of 17,000 kW of energy per year supply the building with energy. With the help of a heat pump with recovery, excess energy can be used in the form of heat.

Progress and measures in 2022

Helios Germany introduced guidelines throughout the country for the establishment of charging infrastructure by service providers for charging electric vehicles and bicycles. Also, an environmental campaign called Patient Earth was also launched for employees to encourage energy-conscious behavior at work as well as at home.

Further, the Helios Sustainability Board agreed on various measures to save energy consumption. For example, a 100-point checklist for the clinics is intended to raise energy-saving potential. The implementation of the checklist is coordinated by regular updates between a task force of the Infrastructure business unit and the clinic energy teams. In addition, control systems for indoor air and refrigeration systems are being installed in the clinics.

Helios Spain updated obsolete facilities by installing new boilers and solar power generations plants in 2022. In addition, efforts have been made to replace lamps that are permanently on for more than 10 hours a day, to replace them with LED lights.

Fresenius Vamed

The respective management teams are responsible for energy and emission management at Fresenius Vamed’s healthcare facilities. The effectiveness of energy management measures in the certified divisions of the business segment is assessed by regular independent audits as part of ISO 50001 certification. In Germany, this certification was implemented together with the Infrastructure business unit of the Fresenius Helios hospitals.

To increase energy efficiency in buildings, the performance of relevant energy consumers is measured, compared with more energy-efficient systems, and finally a decision is made about retrofitting. In this way, efficient as well as economically sensible solutions are used – such as LED lamps. Energy efficiency is also taken into account when new products are purchased.

CO2-neutral power supply

The majority of Fresenius Vamed’s consolidated healthcare facilities in Austria are supplied with CO2-neutral electricity. The business segment also obtains a small amount of energy from its own combined heat and power plants in Germany. Swiss healthcare facilities purchase regional electricity, some of which comes from renewable sources.

Progress and measures in 2022

In 2022, the management approach and governance structure of Fresenius Vamed remained as reported in the previous year. Progress focused on the ongoing internal preparation of the process documentation. Moreover, the business segment concentrated on reducing CO2 emissions. In this regard, an important step was taken by switching the Germany facilities to green electricity.


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Group energy consumption by source

In 2022, Fresenius consumed a total of 5.75 million MWh of energy, a decrease of 1% compared to the previous year. In the reporting year, we focused our activities on energy efficiency measures and the increase of our renewable energy usage across the Fresenius Group. Our main energy sources remain gas and electricity. Newly acquired companies are included in the second year of consolidation, at the latest. If data of the business segments is not available in time, it is extrapolated on the basis of existing data. An adjustment will be made in the next report. Prior-year information was adjusted to conform to the current year’s presentation. Due to rounding, individual numbers and percentages presented in this report may not precisely reflect the absolute figures.

Fresenius Group energy consumption

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MWh in millions 2022 2021 2020 2019 2018
­Fresenius Medical Care1 2.59 2.61 2.49 2.43 2.38
­Fresenius Kabi 1.80 1.77 1.65 1.64 1.65
­Fresenius Helios2 1.17 1.24 1.16 1.09 1.14
­Fresenius Vamed 0.19 0.19 0.18 0.16 0.17
Total 5.75 5.81 5.48 5.32 5.34
1 Data of Fresenius Medical Care include the energy consumption of production sites and the electricity consumption of in-center treatments in dialysis clinics. Some data is subject in part to extrapolations.
2 Data of Fresenius Helios’s fertility services division include in 2022 only the Spanish entities.  

Fresenius Group relative energy consumption

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in MWh 2022 2021 2020 2019 2018
Energy consumption / € 1 million sales 141 155 151 150 159
Energy consumption / FTE 20.5 20.8 19.8 20.3 21.7

Compared with 2021, the Scope 1 and Scope 2 emissions of Fresenius Medical Care decreased by 11% in 2022. The reported Scope 1 emissions decreased by 2%. This decrease can be explained by an overall reduction in energy usage resulting from reduced production activities, the shutdown of a production line in the U.S., and a maintenance project that required gas turbines to be temporarily shut off at the St. Wendel production site. The reported Scope 2 emissions decreased by around 15%. One of the primary activities Fresenius Medical Care engages in to decrease its overall emissions footprint is the procurement of renewable electricity. In 2022, the business segment purchased 250,000 MWh of renewable emission free electricity via Green-e certified Renewable Energy Certificates (RECs). The purchased renewable electricity accounts for 19% of its total electricity consumption. This represents 21% of its global Scope 2 market-based emissions.

Each year, the headquarters of Fresenius Kabi are audited by TÜV Rheinland with regard to the ISO 50001 energy management certification. In 2022, no observations were detected, confirming that the energy management system is in line with the requirements of ISO 50001. Further, Fresenius Kabi successfully achieved the self-imposed target for the continuing roll-out of the ISO 50001 energy management system in accordance with the internal implementation plan, thus expanding the coverage of the management system to additional manufacturing plants in 2022. In addition, the focus in the past fiscal year was on increasing energy efficiency and a best practice program was rolled out at all production sites for evaluation of applicability on-site. Energy performance was also affected in 2022 by higher production at some sites and regulatory validation processes, e. g., the testing of new production lines for quality requirements.

During the past fiscal year, Helios Germany focused on increasing energy efficiency and expanding the share of renewable energy usage. Thus, the business segment has been purchasing green electricity with certificates of origin since the beginning of 2022. The reduction in energy consumption was supported by the measures initiated to achieve the energy reduction target, as explained in the Environmental management and Climate protection – Energy and emissions sections.

In addition, Helios Spain's energy consumption slightly decreased, despite an increasing number of patients compared to the previous year.

At Fresenius Vamed, operations in 2022 concentrated on developing the management approach to climate protection in connection with the ESG (Environment, Social, Governance) process. Besides, relevant collection and control processes were implemented. In 2022, energy consumption was comparable to the previous year. Fresenius Vamed initiated measures to reduce consumption in the reporting year, however, their effectiveness will only become measurable in the coming years.

Fresenius Group GHG emissions Scope 1 and 2

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t CO2 equivalents in thou. 20223
20215 20205 20195 20185
­Fresenius Medical Care1 659 731 766 770 775 776
Scope 1 258 258 263 242 227 219
Scope 2 401 473 503 527 547 557
­Fresenius Kabi 425 441 443 417 409 424
Scope 1 169 169 170 160 169 169
Scope 2 256 272 273 256 239 255
­Fresenius Helios2 206 250 277 287 284 296
Scope 1 113 113 122 112 107 114
Scope 2 93 137 155 175 178 182
­Fresenius Vamed 30 39 39 39 36 38
Scope 1 22 22 23 21 18 19
Scope 2 8 16 16 17 18 19
Total 1,321 1,461 1,524 1,512 1,504 1,534
Scope 1 563 563 578 536 522 521
Scope 2 758 899 946 976 982 1,013

Fresenius Group relative6 GHG emissions Scope 1 and 2

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t CO2 equivalents in thou. 2022 2021 2020 2019 2018
t CO2 equivalents / € 1 million sales 36 41 42 42 46
t CO2 equivalents / FTE 5.2 5.5 5.5 5.8 6.2

In 2022, we enhanced our Group-wide reporting processes by including market-based Scope 2 emissions. The market-based approach reflects energy generated as part of contractual arrangements such as the purchase of renewable electricity. Including market-based Scope 2 emissions in our reporting processes enables us to disclose our emissions reduction activities more transparently going forward. To achieve our Group-wide climate targets, we have established a group of experts who are working on the implementation of appropriate reduction measures across all business segments. In addition, we continuously analyze measures for reducing our resource consumption. When purchasing energy, we consider efficiency requirements and changes in demand. We are exploring the use of renewable energies and already generate our own electricity at numerous sites. For example, we purchased around 645,000 MWh of renewable electricity mainly by using Renewable Energy Certificates (RECs) in 2022. With these efforts we increased the share of renewable electricity consumption from about 4% in 2021 to about 26% in 2022.

In 2022, Fresenius generated a total of 1,321 thousand t CO2e (2021: 1,524 thousand t CO2e5). Our Scope 1 emissions accounts for 563 thousand t CO2e and could be decreased by 3% compared to the previous year (2021: 578 thousand t CO2e). This decrease was due to an overall lower energy consumption this fiscal year, achieved partly as a result of our energy efficiency measures. Our Scope 2 emissions (market-based) of 758 thousand t CO2e already reflect the emission reduction from the increased share of renewable electricity.

1 Data of Fresenius Medical Care encompass the Scope 1 and 2 emissions of production sites and the Scope 2 emissions from electricity consumption resulting from in-center treatments in dialysisDialysisForm ​of ​renal ​replacement ​therapy ​where ​a ​semipermeable ​membrane ​– ​in ​peritoneal ​dialysis ​the ​peritoneum ​of ​the ​patient, ​in ​hemo­ ​dialysis ​the ​membrane ​of ​the ​dialyzer ​– ​is ​used ​to ​clean ​a ​patient’s ​blood. clinics. Some data is subject in part to extrapolations.

2 Data of Fresenius Helios’s fertility services division include in 2022 only the Spanish entities.

3 The Scope 2 emissions are calculated in accordance with the Greenhouse Gas Protocol, following the market-based emission calculation approach for all business segments. The market-based approach reflects energy generated as part of contractual arrangements such as the purchase of renewable electricity. The market-based emissions were calculated using residual mix factors and International Energy Agency (IEA) emission factors.

4 The Scope 2 emissions are calculated in accordance with the Greenhouse Gas Protocol, following the location-based emission calculation approach for all business segments. These emissions are based on the average emission factors in the individual countries.

5 In previous years, Scope 2 emissions were calculated using the location-based approach and the proportion of green electricity purchased was taken into account. In future reporting years, Scope 2 emissions will only be differentiated according to the market-based and location-based approach.

6 The calculation for 2022 is based on market-based emissions. The calculation for 2021-2018 is based on the emissions calculation approach of the previous years.