Guidance for 2026: 10-11% organic growth, EPS up 12-14%
Boston Scientific reported strong Q4 and full-year 2025 results, beating on EPS and revenue, but guided 2026 to a more moderated growth rate (10-11% organic) reflecting market share loss in EP and transitory headwinds in Endoscopy (Axios recall). Management highlighted continued strength in Watchman and diversified growth across other franchises. Q4 2025 organic revenue grew 12.7%, beating guidance; full-year 2025 organic growth was 15.8%.
Buzzberg readGuidance for 2026: 10-11% organic growth, EPS up 12-14%Boston Scientific reported strong Q4 and full-year 2025 results, beating on EPS and revenue, but guided 2026 to a more moderated growth rate (10-11% organic) reflecting market share loss in EP and transitory headwinds in Endoscopy (Axios recall). Management highlighted continued strength in Watchman and diversified growth across other franchises. Q4 2025 organic revenue grew 12.7%, beating guidance; full-year 2025 organic growth was 15.8%.Read full analysisCollapse analysis
Boston Scientific reported strong Q4 and full-year 2025 results, beating on EPS and revenue, but guided 2026 to a more moderated growth rate (10-11% organic) reflecting market share loss in EP and transitory headwinds in Endoscopy (Axios recall). Management highlighted continued strength in Watchman and diversified growth across other franchises. Q4 2025 organic revenue grew 12.7%, beating guidance; full-year 2025 organic growth was 15.8%.
2026 guidance: 10-11% organic revenue growth, EPS growth of 12-14%.
US EP market estimated to be ~70% penetrated with PFA, and BSX expects market growth to slow to 15% in 2026.
Watchman grew 29% in Q4, with the Champion trial results to be presented at ACC in March 2026.
Revenue$5.286B
reported
EPS$0.80
reported
Gross margin74.48%
reported
Op margin22.81%
reported
What changed this quarter
01
Guidance
Guidance for 2026: 10-11% organic growth, EPS up 12-14%
Guidance · revenue to 10.5%
02
Demand
EP market growth estimate shifted down to ~15% for 2026
Management repeatedly emphasized strong growth, market leadership, and reiterated long-range targets despite some near-term headwinds, projecting a confident outlook for 2026.
03
Demand
Watchman growth continued at 29% in Q4, no impact from competitor trials
EP market growth estimate shifted down to ~15% for 2026. Management repeatedly emphasized strong growth, market leadership, and reiterated long-range targets despite some near-term headwinds, projecting a confident outlook for 2026.
04
Pipeline
Champion trial results to be presented at ACC, potential first-line therapy
US EP market estimated to be ~70% penetrated with PFA, and BSX expects market growth to slow to 15% in 2026.
Demand
Demand
Bookings & conversion
EP market growth estimate shifted down to ~15% for 2026. Management repeatedly emphasized strong growth, market leadership, and reiterated long-range targets despite some near-term headwinds, projecting a confident outlook for 2026.
Tone · Confident
Management repeatedly emphasized strong growth, market leadership, and reiterated long-range targets despite some near-term headwinds, projecting a confident outlook for 2026.
Bottlenecks
Permittingpersistent
Permitting is delaying capacity
“We continue to invest in our ecosystem approach to innovation and recently received approval and limited market release in both Europe and the U.S.”
US EP market penetrated ~70% with PFA in 2025; BSX expects market growth to normalize to ~15% in 2026, down from an estimated 18-20% in Q4 2025, with BSX explicitly planning to lose share due to competitive launches.
The Axios product removal (manufacturing variation) is expected to depress Endoscopy growth in H1 2026, with full market re-entry by mid-year.
“we initiated a product removal for certain sides of our Axios device, due to a manufacturing variation. We do understand the issue and are working to bring these unique devices back to market in full by mid-year”
… exiting the year with strong double-digit growth across all major global markets. We are extremely pleased with the performance of this franchise, with above-market growth driven by the strong adoption of concomitant procedures. We have now treated more than 25,000 patients concomitantly with Watchman. As we look ahead, we continue to invest in our portfolio, clinical evidence, and driving efficiencies for physicians. In the quarter, we announced a strategic partnership with Siemens Healthineers to develop and commercialize their next-generation 4D ice catheter called AccuNav, intended to offer physicians an innovative imaging option for standalone watchmen or Farrow watch procedures. And last month, we completed enrollment in the Simplify clinical trial, evaluating two single-drug regimens, as post-procedural alternatives to dual antiplatelet therapy, with data expected in the second half of 26. Importantly, our champion trial, a large randomized trial studying Watchman Flex versus novel oral anticoagulation was accepted and will be presented as a late breaker at ECC on Saturday, March 28th. If positive, this data would support Watchman as a first-line therapy for stroke …
… And within the quarter, we received expanded reimbursement to coverage for the intracept procedure, initiated a full market launch of the Intracept Edge Stylet designed to improve the treatment experience. Our cardiovascular segment delivered 16% growth operationally in organic in fourth quarter and 22% operationally and 21% organic on a full year basis. In January, we announced agreement to acquire Penumbra, which is expected to close in 26. Penumbra offers a highly differentiated portfolio that operates in high growth segments where Boston Scientific lacks offerings, including mechanical thrombectomy and neurovascular. The deal is both strategically and financially attractive to Boston Scientific and delivers significant value to patients and customers globally. Within cardiovascular, interventional cardiology therapy sales grew 10% in Q4 and 8% on a full-year basis. We're very proud of the Coronary Therapies franchise, delivering double-digit growth in both the quarter and full year as we have shifted our underlying business to high-growth markets. Agent DCV has been a standout performer all year with its differentiated clinical benefit and reimbursement support, lifting our …
US EP market penetrated ~70% with PFA in 2025; BSX expects market growth to normalize to ~15% in 2026, down from an estimated 18-20% in Q4 2025, with BSX explicitly planning to lose share due to competitive launches. — Signals the high-growth phase in US PFA is maturing; competitive share gains are expected to accelerate, pressuring all players on volume and pricing.
I think we've been pretty consistent with our messaging on EP. We do think the market's 18 to 20, like we said. I think some maybe have overshot the market growth in Q4. When you're the highest market share leader in PFA and competitors are coming out, we planned and we did expect to lose some share. given the competitive launches that are coming out and giving our really dominant market share position going into 2025. So we did anticipate that. And we are also very comfortable to say, as we looked at the end of 26, that we'll be the clear BFA market leader. And we also think our EP business will grow faster than 15%. So with new interest coming, it's not surprising that we lost some share. But the overall EP growth of 35%, I think, is quite impressive given the size of that business now and grew faster overall than our competitors. On the first quarter guide, we guided full year to 10 to 11, which we think is strong guidance given where we are early in the year here. And 8.5% to 10%, it's simply two factors, really. One is our toughest comp of the year. And secondly, we do have about 150 bps of impact from the Acura discontinuation along with the Axios withdrawal. Well, not full …
Intracept procedure received expanded reimbursement coverage, and BSX is launching the Intracept Edge Stylet to improve the treatment experience. — Expanded coverage and new tooling may accelerate adoption of basivertebral nerve ablation, potentially impacting competitors like SI-BONE.
… improving efficiency and programming time. The pain franchise continues to strengthen and grew high single digits on a full year basis. This strong growth is a result of a deliberate strategy to expand our pain portfolio to bring options to the physicians, patients, and hospitals we serve. This is further strengthened by the close of the NALU acquisition, adding peripheral nerve stimulation, PNS, to our portfolio. And within the quarter, we received expanded reimbursement to coverage for the intracept procedure, initiated a full market launch of the Intracept Edge Stylet designed to improve the treatment experience. Our cardiovascular segment delivered 16% growth operationally in organic in fourth quarter and 22% operationally and 21% organic on a full year basis. In January, we announced agreement to acquire Penumbra, which is expected to close in 26. Penumbra offers a highly differentiated portfolio that operates in high growth segments where Boston Scientific lacks offerings, including mechanical thrombectomy and neurovascular. The deal is both strategically and financially attractive to Boston Scientific and delivers significant value to patients and customers globally. …
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