Boston Scientific reported a solid Q1 but significantly lowered its full-year 2026 guidance due to unexpected share loss in the electrophysiology (PFA) market, deceleration in standalone Watchman procedures, and commercial disruptions in urology. Management remains confident in the long-term pipeline but will be investing to defend its competitive position. Q1 revenue grew 9.4% organically (in-line with guidance), while adjusted EPS was $0.80 (high-end of guidance).
Buzzberg readFull-year organic growth guidance cut to 6.5-8%Boston Scientific reported a solid Q1 but significantly lowered its full-year 2026 guidance due to unexpected share loss in the electrophysiology (PFA) market, deceleration in standalone Watchman procedures, and commercial disruptions in urology. Management remains confident in the long-term pipeline but will be investing to defend its competitive position. Q1 revenue grew 9.4% organically (in-line with guidance), while adjusted EPS was $0.80 (high-end of guidance).Read full analysisCollapse analysis
Boston Scientific reported a solid Q1 but significantly lowered its full-year 2026 guidance due to unexpected share loss in the electrophysiology (PFA) market, deceleration in standalone Watchman procedures, and commercial disruptions in urology. Management remains confident in the long-term pipeline but will be investing to defend its competitive position. Q1 revenue grew 9.4% organically (in-line with guidance), while adjusted EPS was $0.80 (high-end of guidance).
Full-year 2026 organic revenue growth guidance was cut to 6.5-8% (from ~9-10%), and EPS guidance was cut to $3.34-$3.41.
Major drivers of the guide-down are EP share loss to Medtronic/J&J/Abbott, weaker standalone Watchman volumes vs. strong concomitant growth, and urology commercial disruption.
Global EP growth is now guided to ~10% (from ~20%), with US EP expected to grow only mid-single-digits for the year.
Revenue$5.203B
-2% QoQ
EPS$0.80
+0% QoQ
Gross margin69.44%
reported
Op margin20.6%
reported
What changed this quarter
01
Guidance
Full-year organic growth guidance cut to 6.5-8%
Guidance · revenue to 6%
02
Demand
Watchman US growth decelerating despite Champion data
Management acknowledged a challenging quarter and cut full-year guidance, expressing disappointment and admitting to unanticipated headwinds, while emphasizing confidence in long-term strategy.
03
Guidance
EP growth outlook lowered to 10% globally
Guidance · revenue to 6%
04
Demand
Urology growth disappoints at 1% in Q1
Watchman US growth decelerating despite Champion data. Management acknowledged a challenging quarter and cut full-year guidance, expressing disappointment and admitting to unanticipated headwinds, while emphasizing confidence in long-term strategy.
Demand
Demand
Bookings & conversion
Watchman US growth decelerating despite Champion data. Management acknowledged a challenging quarter and cut full-year guidance, expressing disappointment and admitting to unanticipated headwinds, while emphasizing confidence in long-term strategy.
Tone · Cautious
Management acknowledged a challenging quarter and cut full-year guidance, expressing disappointment and admitting to unanticipated headwinds, while emphasizing confidence in long-term strategy.
Bottlenecks
Cooling
Cooling capacity is constraining deployment
“Last year, we did announce our intent to discontinue the Polarex cryocatheter, but have accelerated that timing given some recent safety events and the availability of non-thermal ablation technologies.”
The US EP business (including PFA) is expected to be roughly flat to low single-digit growth for 2Q-4Q, a significant deceleration from historical performance, as BSX loses more share than anticipated to Medtronic, J&J, and Abbott.
Watchman standalone procedure volumes are decelerating, with cases shifting toward concomitant procedures done by electrophysiologists rather than interventional cardiologists, as hospitals prioritize higher-value procedures.
“We are seeing pressure in kind of the standalone watchman implant business, which historically has not been a challenge for us.”
Urology growth is being hampered by commercial disruptions in the sacral neuromodulation business, requiring significant hiring and retraining of sales reps, with performance expected to improve quarter-over-quarter.
“Our cyclone modulation business continues to see impact on commercial model disruptions. And importantly, within first quarter, we have hired and trained a significant number of new sales and clinical reps.”
The company is repurchasing $2B of shares in Q2, funded by cash on hand, signaling confidence in the stock despite the guidance cut.
“We intend to repurchase approximately $2 billion of our shares during the second quarter, subject to market conditions and applicable securities laws.”
The US EP business (including PFA) is expected to be roughly flat to low single-digit growth for 2Q-4Q, a significant deceleration from historical performance, as BSX loses more share than anticipated to Medtronic, J&J, and Abbott. — This indicates that the US PFA competitive dynamic is shifting faster than expected, and BSX's leadership position is being challenged more intensely in the near term.
“Medtronic continues to be a solid competitor. J&J is enhancing their footprint in PFA, and Abbott at its early stages of launch in the U.S.”
Good morning. Thanks for taking the question. I guess on EP, just maybe a little bit more color on the market and share assumptions, how they've changed. Where is this share pressure coming from, Mike? And On USEP, you know, sales have been flattish for the past three or four quarters. Should we expect relatively flat USEP sales, you know, for the rest of the year? And what does that mean for 2027? I think people are trying to understand, you know, when you can get back to market growth in EP. Thank you.
… be approximately 10%. In the U.S. particularly, we expect mid-single-digit growth for the U.S. business, which implies a flat 2Q to 4Q. Flat to low single-digit. And international, about 20%. So call it flat to low single-digit U.S., U.S. mid-single-digit for the year. And then, so that's the story there. What's different about it... from our previous commentaries where we said we were a grow hat market. We're disappointed to bring that guy's level down, but we think it's appropriate. We aim to be, and we have high confidence that we'll maintain PFA leadership in the U.S., internationally, globally, in 26, and throughout this LRP. And we are very excited about the product launches that we have, in particular the three big ones coming up. 27 are third-generation Faribaults, differentiated ice platform, and we think a very disruptive Paraflex platform all in the next two and a half years. But today we are seeing increased competition. You know there's three other large players in the marketplace. We've made commentary before. Medtronic continues to be a solid competitor. J&J is enhancing their footprint in PFA, and Abbott at its early stages of launch in the U.S. In Europe, we're really proud of our European performance, where all three of those companies are performing. We continue to grow at a 20% plus clip, where we quite frankly have quite advanced mapping capability and platform, and doing very well there. We did expect a little bit more share erosion than we had anticipated in the past and previous guide, but we think this is the perfect guide to do. It allows us to continue to have PFA market leadership while we're bringing that platform forward. Our mappers, which we've made a massive investment over the past two and a half years, continue to get stronger and stronger every quarter. We continue to install more and more Opal mapping platforms. Our mappers get more sophisticated, and we continue to add new catheters to the mix along with Fairpoint, which we recently launched. So we'll continue to grow the mapping platform, continue to invest in that commercial capabilities. You'll see more direct investments in Watchman in particular, so we'll invest both commercially and marketing, both our watchmen and our EP businesses. But we're confident we'll maintain PFA leadership, but we are going to see a bit more share than we anticipated earlier in the year.
… performance. We expect to ramp our manufacturing supply chain over the course of the year and continue to anticipate launching our below-the-knee indication in the second half. In first quarter, positive data from HyPyto was presented at ECC, evaluating ECOS plus anticoagulation versus anticoagulation alone. providing new clinical evidence that can help physicians make more informed treatment decisions for patients with acute pulmonary embolism. We remain excited about the opportunity to have the Penumbra team and highly differentiate portfolios at Boston Scientific. We anticipate that the deal will close on the 2nd of April 26th, subject to the Penumbra shoulder vote on May 6th, and the receipt of the remaining obligatory clearances. Our interventional oncology business had a nice quarter with organic cells growing 15% driven by our broad offering of cancer therapy technologies. Within the quarter, we received FDA clearance of any day dosing and initiated a limited market release. Any day dosing is enabled by the TheraSphere 360 Y90 management platform, allowing physicians to schedule treatments on more days of the week and offering more streamlined ordering and operational …
🍪 Cookies
We use cookies to operate this site and for analytics. Declining won't affect your access to content.