Boston Scientific Beats Q4 Estimates, Guides 2026 Growth

Boston Scientific reported its fourth-quarter 2025 results on Feb. 4, with both top and bottom lines exceeding the company's guidance ranges and topping consensus estimates. Closed acquisitions contributed 160 basis points to sales, resulting in 12.7% organic revenue growth. The company generated more than $20 billion in sales in 2025, with mid-teens growth for the second consecutive year.

However, supply-chain issues weighed on Urology's performance, and the Axonics integration caused greater commercial disruption than initially anticipated. In the quarter, Boston Scientific lost share in Electrophysiology (EP) amid competitive product launches. Management indicated that tough comps and product discontinuation will impact the near-term financial outlook. Shares of Boston Scientific tumbled 17.6% following the earnings announcement.

In the past six months, Boston Scientific stock has dipped 28.7%, significantly underperforming its industry's 11.9% decline. Shares have also lagged competitors Edwards Lifesciences and Stryker, which have fallen 2.3% and 3.4%, respectively. The broader Medical sector has gained 11.7% in the same time frame.

The WATCHMAN business delivered 29% year-over-year growth in the fourth quarter, driven by strong adoption of U.S. concomitant procedures, and posted strong double-digit growth across all major global markets for the full year. Boston Scientific also announced a strategic partnership with Siemens Healthineers to develop and commercialize its next-generation 4D ICE catheter called AcuNav, aimed at enhancing imaging for stand-alone WATCHMAN or FARAWATCH procedures. Neuromodulation sales grew 10% in the fourth quarter and 8% organically for the full year, led by the Cartesia X and Illumina 3D offerings in the brain franchise. The Nalu acquisition strengthened the Neuromodulation lineup by adding peripheral nerve stimulation therapy, and the company received expanded reimbursement coverage for the Intracept procedure and initiated a full market launch of the Intracept EDGE Stylet.

Sales in the Asia-Pacific region jumped 15% operationally in the fourth quarter and 14% for the year, driven by strength in Japan and China. Japan's growth was boosted by WATCHMAN and EP, backed by OPAL Mapping System placements and increased FARAPULSE catheter utilization. China had another quarter of double-digit growth, driven by EP, WATCHMAN and Interventional Cardiology Therapies.

The company expects organic growth between 10% and 11% in 2026, excluding foreign currency fluctuations and certain acquisitions and divestitures. Neuromodulation is projected to be a top performer, while Urology is anticipated to return to market growth with supply-chain issues resolved and upcoming product launches. Boston Scientific exited 2025 with roughly 65% share in the pulsed field ablation (PFA) market, and management anticipates gaining above the expected 15% market growth rate, supported by mapping system expansion and global PFA adoption. EP momentum is also expected to continue in China in 2026, supported by the NMPA approval of the FARAWAVE NAV device and expanded persistent atrial fibrillation (AFib) indications.

In January, Boston Scientific announced agreements to acquire Valencia Technologies and Penumbra, enabling entry into strategic urology and cardiovascular adjacencies, respectively. The CHAMPION trial comparing WATCHMAN FLX to novel oral anticoagulation will be presented as a late breaker at ACC in March. Positive data could support WATCHMAN as a first-line stroke prevention therapy and expand the indicated population from roughly 5 million to 20 million worldwide.

The company anticipates full-year adjusted gross margin to remain roughly in line with 2025, as favorable product mix will be largely offset by global supply-chain investments and the annualization of tariffs. Adjusted operating margin is projected to expand 50-75 basis points, with adjusted EPS in the band of $3.43-$3.49, implying 12%-14% growth. First-quarter 2026 operational and organic revenue growth is guided at 8.5% to 10%, including an approximate 150 basis points impact from the discontinuation of the ACURATE valve.