Boston Scientific Corporation Q4 FY2025 earnings call

Key Points:

• In 2025, Boston Scientific achieved over $20B in sales with mid-teens growth. Q4 total company operational sales grew 14%, organic sales 13%; full year operational sales 19%, organic 16%. Q4 adjusted EPS $0.80, full year $3.06. Adjusted operating margins expanded to 28%.
• 2026 outlook: Organic growth guidance for Q1 8.5%-10%, full year 10%-11%; adjusted EPS Q1 $0.78-$0.80, full year $3.43-$3.49.
• Regional performance: U.S. Q4 operational growth 17%, full year 26%; Europe, Middle East, Africa Q4 5%, full year 3%; Asia Pac Q4 15%, full year 14%.
• Business unit highlights: EP grew strong double digits in Q4; WATCHMAN had outstanding growth; Endoscopy had product removal impact; Neuromodulation grew well; Interventional Oncology & Embolization had strong growth; Cardiac Rhythm Management had 1% growth; Urology had mixed results.
• Acquisitions: Recently closed Nalu Medical, announced acquisition of Valencia Technologies and Penumbra.

Cardiovascular: Fourth quarter operational and organic growth 16%, full year 22% operational and 21% organic growth. WATCHMAN: Q4 growth 29%, full year strong double-digit growth across all major global markets. EP: Q4 organic growth 35%, full year 73% growth. Endoscopy: Q4 and full year organic growth 8%, but had product removal impact on AXIOS device. Neuromodulation: Q4 growth 10%, full year 8% organic growth. Interventional Oncology & Embolization: Q4 operational growth 17%, organic 12%, full year nearly $1B sales. Cardiac Rhythm Management: Q4 and full year organic growth 1%. Urology: Q4 operational growth 13%, full year 3% organic; full year operational growth 23%, organic 5%.

Guidance:

• Q1 2026 organic growth expected 8.5%-10%, full year 2026 organic growth 10%-11%.
• Q1 2026 adjusted EPS guidance $0.78-$0.80, full year 2026 adjusted EPS $3.43-$3.49.
• Full year 2026 adjusted gross margin expected roughly in line with 2025; adjusted operating margin expected to expand 50-75 basis points.

Risks:

• Product removal issues: Impact from AXIOS device manufacturing variation and ACURATE discontinuation affecting first half of 2026.
• Competition: Potential challenges from competitors in various product segments.
• Regulatory: Uncertainties related to regulatory approvals and reimbursements for new products.

Q: Robbie Marcus from JPMorgan asked about U.S. EP and WATCHMAN performance.

A: Overall pleased with quarter, EP grew 35%, WATCHMAN 29%. Market for EP in Q4 was 18%-20%, expected to grow 15% in 2026.

Q: Larry Biegelsen from Wells Fargo asked about WATCHMAN and CHAMPION trial.

A: CHAMPION trial results to be presented at ACC, co-primary endpoints include noninferiority for combined endpoint and bleeding; no impact seen from recent trials yet.

Q: Travis Steed from Bank of America pushed on US EP.

A: EP market expected 18%-20% in Q4, lost some share due to competitors' launches, but expected to be clear market leader in PFA by year-end.

Q: Rick Wise from Stifel asked about EP cadence and FARAPOINT.

A: EP expected to grow above market, FARAPOINT to expand portfolio, with strong pipeline and new products driving growth.

Q: Joanne Wuensch from Citibank asked about second half acceleration.

A: Expect stronger performance in multiple business units in 2026, including PI, neuromod, and CRM, with new product launches and investments.

Q: David Roman from Goldman Sachs asked about diversification.

A: Confident in non-EP and WATCHMAN businesses, with strong performance in ICTX, Interventional Oncology, and others, supported by organic R&D and tuck-in M&A.

Q: Patrick Wood from Morgan Stanley asked about vascular sales forces.

A: Strong commercial scale in PI and cardiology, Penumbra acquisition to enter new markets with scaled sales force.

Q: Danielle Antalffy from UBS asked about EP lab capacity.

A: Efficiency gains built in, but growth in EP market expected 15%, with ASCs and cath lab repurposing to drive growth.

Q: Michael Polark from Wolfe Research asked about ICE partnership.

A: Partnership with Siemens for 4D catheter is premium, 2D ICE is different price point, coexisting in portfolio.

Q: Matt Taylor from Jefferies asked about CHAMPION outcomes.

A: Bleeding endpoint powered as superiority, positive result could boost concomitant and indication; takes time to build new indication.

Q: Josh Jennings from TD Cowen asked about LRP targets.

A: Confident in hitting 10%-plus organic growth, 150 bps margin improvement, with Penumbra acquisition enhancing position.

Q: Chris Pasquale from Nephron Research asked about U.S. PFA penetration.

A: 70% penetration in U.S. PFA, remaining 30% to penetrate with focus on other procedure categories like SBT or VT, needing product and data support.