Boston Scientific’s fourth quarter results were met with a significant negative market reaction, despite meeting revenue expectations and delivering adjusted earnings above analyst consensus. Management pointed to broad-based growth, with electrophysiology (EP), WATCHMAN, interventional oncology, and neuromodulation cited as standouts. However, concerns emerged around sequential stagnation in U.S. EP sales and a modest miss in U.S. WATCHMAN, both key franchises for Boston Scientific’s ongoing momentum. CEO Michael Mahoney acknowledged these issues, stating, “We anticipated some share loss in EP given competitive launches, but we remain confident in our above-market growth expectations.”
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Boston Scientific (BSX) Q4 CY2025 Highlights:
- Revenue: $5.29 billion vs analyst estimates of $5.27 billion (15.9% year-on-year growth, in line)
- Adjusted EPS: $0.80 vs analyst estimates of $0.78 (2.4% beat)
- Adjusted EBITDA: $1.56 billion vs analyst estimates of $1.59 billion (29.5% margin, 2% miss)
- Revenue Guidance for Q1 CY2026 is $5.19 billion at the midpoint, roughly in line with what analysts were expecting
- Adjusted EPS guidance for the upcoming financial year 2026 is $3.46 at the midpoint, in line with analyst estimates
- Operating Margin: 15.6%, in line with the same quarter last year
- Organic Revenue rose 12.7% year on year (beat)
- Market Capitalization: $110.1 billion
While we enjoy listening to the management's commentary, our favorite part of earnings calls are the analyst questions. Those are unscripted and can often highlight topics that management teams would rather avoid or topics where the answer is complicated. Here is what has caught our attention.
Our Top 5 Analyst Questions From Boston Scientific’s Q4 Earnings Call
- Robert Marcus (JPMorgan): Pressed management on sequential trends in U.S. EP and WATCHMAN, asking what drove the softness and whether growth expectations for these franchises should be lowered. CEO Michael Mahoney reiterated confidence in above-market growth, noting share shifts were anticipated given new competitive launches.
- Larry Biegelsen (Wells Fargo): Asked if recent clinical trial results impacted WATCHMAN adoption and about expectations for the CHAMPION trial. Dr. Ken Stein confirmed “no impact” from recent trials and explained both efficacy and bleeding endpoints will be critical in the upcoming data.
- Travis Steed (Bank of America): Questioned whether flat U.S. EP growth and the Q1 revenue guide implied market share loss or market slowdown. Management clarified that share loss was expected due to high prior penetration and new entrants but maintained their leadership position and long-term growth outlook.
- David Roman (Goldman Sachs): Inquired about diversification beyond EP and WATCHMAN, given challenges in urology and endoscopy. Mahoney explained that supply chain improvements and new product launches should drive stronger performance in these areas in 2026.
- Matthew Taylor (Jefferies): Sought clarification on the potential impact of the CHAMPION trial for WATCHMAN. Dr. Stein noted that a positive result could expand indications and strengthen current use, but broader market adoption would require updated guidelines and reimbursement.
Catalysts in Upcoming Quarters
Looking ahead, the StockStory team will be closely monitoring (1) the rollout and adoption of new EP and WATCHMAN product iterations, (2) resolution of supply chain and product disruptions in urology and endoscopy, and (3) the integration and performance of recent acquisitions, particularly Penumbra and Valencia Technologies. The outcome of the CHAMPION trial and progress on clinical studies in coronary and oncology therapies will also be crucial signposts for sustained growth.
Boston Scientific currently trades at $74.73, down from $91.62 just before the earnings. Is the company at an inflection point that warrants a buy or sell? The answer lies in our full research report (it’s free).
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