Detailed Narrative
Strong Q4 and Full Year 2025 Performance
Boston Scientific exceeded its financial goals for 2025, achieving over $20 billion in sales and mid-teens growth for the second consecutive year. Q4 organic sales grew 13%, reaching the high end of guidance, while full year organic sales grew 15.8%, surpassing the 15.5% guidance. Adjusted EPS for Q4 was $0.80, and for the full year, it reached $3.06, both exceeding guidance. The company also expanded adjusted operating margins by 100 basis points to 28% for the full year.
2026 Outlook and Strategic Investments
The company projects continued strong performance in 2026, guiding to 10% to 11% organic growth and 12% to 14% adjusted EPS growth for the full year. This guidance includes investments in the global supply chain and accounts for the annualization of tariffs. Strategic acquisitions like Valencia Technologies and Penumbra are expected to close in 2026, further enhancing the company's portfolio in high-growth segments, and are seen as strategically and financially attractive.
Regional Performance Highlights
The U.S. market demonstrated exceptional performance, growing 17% operationally in Q4 and 26% for the full year, driven by EP, WATCHMAN, and ICTx. Asia Pacific grew 15% operationally in Q4, with strong contributions from Japan (WATCHMAN, EP, FARAPULSE) and China (EP, WATCHMAN, ICTx). EMEA growth was impacted by the ACURATE discontinuation but is expected to improve in the second half of 2026 once the impact annualizes.
Business Unit Performance and Challenges
While EP and WATCHMAN continued their strong growth trajectories, some business units faced challenges. Urology was below expectations in 2025 due to supply chain issues and integration complexities, though a return to market growth is anticipated in 2026 with new product launches. Endoscopy will see lower growth in H1 2026 due to a product removal for certain AXIOS device sizes, with a return to full market by midyear. Neuromodulation, PI, and CRM are expected to show stronger performance in 2026.
Cardiovascular Segment Reorganization and Pipeline
The Cardiovascular segment delivered robust growth, with Interventional Cardiology Therapies sales growing 10% in Q4. The company reorganized its Peripheral Interventions divisions, aligning peripheral vascular with Interventional Cardiology Therapies to form Interventional Cardiology & Vascular Therapies, aiming to amplify commercial and R&D opportunities. Key pipeline advancements include the FRACTURE trial for SEISMIQ IVL System and the HI-PEITHO study for EKOS.
EP and WATCHMAN Momentum
Global EP organic growth was 35% in Q4, driven by PFA catheter utilization and OPAL placements. The company expects the EP market to grow approximately 15% in 2026 and aims to outpace this growth. WATCHMAN delivered 29% growth in Q4, benefiting from strong adoption of concomitant procedures. The upcoming CHAMPION trial results are highly anticipated, with potential to expand the indicated patient population significantly if positive, from 5 million to 20 million globally.
Clinical Trial Milestones
Enrollment was completed for the FRACTURE trial (SEISMIQ IVL System) with data anticipated later in 2026, and the SIMPLAAFY clinical trial (WATCHMAN post-procedural alternatives) with data expected in H2 2026. The CHAMPION trial (WATCHMAN FLX vs. OAC) results will be presented as a late breaker at ACC, potentially positioning WATCHMAN as a first-line therapy for stroke prevention. Enrollment also began in the SYNCHRONICITY trial for conduction system pacing.