Integer Holdings (ITGR)

Medical technology company Integer Holdings (NYSE:ITGR) met Wall Street’s revenue expectations in Q3 CY2025, with sales up 8.4% year on year to $467.7 million. On the other hand, the company’s full-year revenue guidance of $1.85 billion at the midpoint came in 1% below analysts’ estimates. Its non-GAAP profit of $1.79 per share was 6.8% above analysts’ consensus estimates.

Company Overview

With its name reflecting the mathematical term for "whole" or "complete," Integer Holdings (NYSE:ITGR) is a medical device outsource manufacturer that produces components and systems for cardiac, vascular, neurological, and other medical applications.

The medical devices industry operates a business model that balances steady demand with significant investments in innovation and regulatory compliance. The industry benefits from recurring revenue streams tied to consumables, maintenance services, and incremental upgrades to the latest technologies, although specialty devices are more niche. The capital-intensive nature of product development, coupled with lengthy regulatory pathways and the need for clinical validation, can weigh on profitability and timelines. In addition, there are constant pricing pressures from healthcare systems and insurers maximizing cost efficiency. Over the next several years, one tailwind is demographic–aging populations means rising chronic disease rates that drive greater demand for medical interventions and monitoring solutions. Advances in digital health, such as remote patient monitoring and smart devices, are also expected to unlock new demand by shortening upgrade cycles. On the other hand, the industry faces headwinds from pricing and reimbursement pressures as healthcare providers increasingly adopt value-based care models. Additionally, the integration of cybersecurity for connected devices adds further risk and complexity for device manufacturers.

Integer Holdings competes with other medical device contract manufacturers including Jabil (NYSE:JBL), TE Connectivity (NYSE:TEL), and Flex (NASDAQ:FLEX), as well as specialized medical component manufacturers like Greatbatch Medical (which Integer acquired) and privately-held companies such as Cirtec Medical and Viant Medical.

Larger companies benefit from economies of scale, where fixed costs like infrastructure, technology, and administration are spread over a higher volume of goods or services, reducing the cost per unit. Scale can also lead to bargaining power with suppliers, greater brand recognition, and more investment firepower. A virtuous cycle can ensue if a scaled company plays its cards right.

With just $1.83 billion in revenue over the past 12 months, Integer Holdings is a small company in an industry where scale matters. This makes it difficult to build trust with customers because healthcare is heavily regulated, complex, and resource-intensive.

A company’s long-term sales performance is one signal of its overall quality. Even a bad business can shine for one or two quarters, but a top-tier one grows for years. Thankfully, Integer Holdings’s 10.1% annualized revenue growth over the last five years was decent. Its growth was slightly above the average healthcare company and shows its offerings resonate with customers.

Long-term growth is the most important, but within healthcare, a half-decade historical view may miss new innovations or demand cycles. Integer Holdings’s annualized revenue growth of 9.6% over the last two years aligns with its five-year trend, suggesting its demand was stable.

We can dig further into the company’s sales dynamics by analyzing its organic revenue, which strips out one-time events like acquisitions and currency fluctuations that don’t accurately reflect its fundamentals. Over the last two years, Integer Holdings’s organic revenue averaged 7.5% year-on-year growth. Because this number is lower than its two-year revenue growth, we can see that some mixture of acquisitions and foreign exchange rates boosted its headline results.

This quarter, Integer Holdings grew its revenue by 8.4% year on year, and its $467.7 million of revenue was in line with Wall Street’s estimates.

Looking ahead, sell-side analysts expect revenue to grow 7.3% over the next 12 months, a slight deceleration versus the last two years. Despite the slowdown, this projection is above average for the sector and indicates the market is forecasting some success for its newer products and services.

Integer Holdings’s operating margin might fluctuated slightly over the last 12 months but has generally stayed the same, averaging 11% over the last five years. This profitability was higher than the broader healthcare sector, showing it did a decent job managing its expenses.

Looking at the trend in its profitability, Integer Holdings’s operating margin of 12.1% for the trailing 12 months may be around the same as five years ago, but it has increased by 1.6 percentage points over the last two years.

In Q3, Integer Holdings generated an operating margin profit margin of 12.1%, down 1.4 percentage points year on year. This reduction is quite minuscule and indicates the company’s overall cost structure has been relatively stable.

We track the long-term change in earnings per share (EPS) for the same reason as long-term revenue growth. Compared to revenue, however, EPS highlights whether a company’s growth is profitable.

Integer Holdings’s EPS grew at a spectacular 12.9% compounded annual growth rate over the last five years, higher than its 10.1% annualized revenue growth. However, we take this with a grain of salt because its operating margin didn’t improve and it didn’t repurchase its shares, meaning the delta came from reduced interest expenses or taxes.

In Q3, Integer Holdings reported adjusted EPS of $1.79, up from $1.43 in the same quarter last year. This print beat analysts’ estimates by 6.8%. Over the next 12 months, Wall Street expects Integer Holdings’s full-year EPS of $6.08 to grow 14.9%.

Free cash flow isn't a prominently featured metric in company financials and earnings releases, but we think it's telling because it accounts for all operating and capital expenses, making it tough to manipulate. Cash is king.

Integer Holdings has shown decent cash profitability, giving it some flexibility to reinvest or return capital to investors. The company’s free cash flow margin averaged 5.6% over the last five years, slightly better than the broader healthcare sector.

Taking a step back, we can see that Integer Holdings’s margin dropped by 7.1 percentage points during that time. If its declines continue, it could signal increasing investment needs and capital intensity.

EPS and free cash flow tell us whether a company was profitable while growing its revenue. But was it capital-efficient? A company’s ROIC explains this by showing how much operating profit it makes compared to the money it has raised (debt and equity).

Integer Holdings historically did a mediocre job investing in profitable growth initiatives. Its five-year average ROIC was 5.6%, somewhat low compared to the best healthcare companies that consistently pump out 20%+.

We like to invest in businesses with high returns, but the trend in a company’s ROIC is what often surprises the market and moves the stock price. Fortunately, Integer Holdings’s ROIC averaged 1.3 percentage point increases over the last few years. This is a good sign, and we hope the company can continue improving.

Integer Holdings reported $58.94 million of cash and $1.20 billion of debt on its balance sheet in the most recent quarter. As investors in high-quality companies, we primarily focus on two things: 1) that a company’s debt level isn’t too high and 2) that its interest payments are not excessively burdening the business.

With $373.9 million of EBITDA over the last 12 months, we view Integer Holdings’s 3.1× net-debt-to-EBITDA ratio as safe. We also see its $28.43 million of annual interest expenses as appropriate. The company’s profits give it plenty of breathing room, allowing it to continue investing in growth initiatives.

It was good to see Integer Holdings beat analysts’ EPS expectations this quarter. We were also happy its organic revenue was in line with Wall Street’s estimates. On the other hand, its full-year revenue and full-year EBITDA guidance both fell short of Wall Street’s estimates. Overall, this quarter could have been better. The stock traded down 17.6% to $90 immediately after reporting.

Updated: December 3, 2025 at 10:57 PM EST

Are you wondering whether to buy Integer Holdings or pass? We urge investors to not only consider the latest earnings results but also longer-term business quality and valuation as well.

Integer Holdings isn’t a terrible business, but it doesn’t pass our quality test. Although its revenue growth was good over the last five years, it’s expected to deteriorate over the next 12 months and its subscale operations give it fewer distribution channels than its larger rivals. And while the company’s spectacular EPS growth over the last five years shows its profits are trickling down to shareholders, the downside is its cash profitability fell over the last five years.

Integer Holdings’s P/E ratio based on the next 12 months is 11.2x. This valuation multiple is fair, but we don’t have much faith in the company. We're pretty confident there are superior stocks to buy right now.

Wall Street analysts have a consensus one-year price target of $84.57 on the company (compared to the current share price of $70.63).

Although the price target is bullish, readers should exercise caution because analysts tend to be overly optimistic. The firms they work for, often big banks, have relationships with companies that extend into fundraising, M&A advisory, and other rewarding business lines. As a result, they typically hesitate to say bad things for fear they will lose out. We at StockStory do not suffer from such conflicts of interest, so we’ll always tell it like it is.