Boston Scientific : Q1 2026 Financial and Operational Highlights

Published: 2026-04-22 07:14:22 ET BSX

Published on 04/22/2026 at 07:14 am EDT

Q1 2026 Highlights

April 22, 2026

Financial Highlights

Operational Highlights

• +11.6% reported, +9.4% operational*/organic* Y/Y

As reported: $0.90 vs. $0.45 Q1:25

Adjusted*: $0.80 vs. $0.75 Q1:25

As reported: 69.4%, +60 bps Y/Y

Adjusted*: 70.5%, (100) bps Y/Y

As reported: 21.2%, +140 bps Y/Y

Adjusted*: 28.0%, (90) bps Y/Y

As reported net sales growth: 5.5% - 7.5%

Organic* net sales growth: 5.0% - 7.0%

Adjusted EPS*: $0.82 - $0.84

As reported net sales growth: 7.0% - 8.5%

Organic* net sales growth: 6.5% - 8.0%

Adjusted EPS*: $3.34 - $3.41

Announced clinical trial results that were presented in late-breaking sessions at the 75th Annual Scientific Session of the American College of Cardiology and simultaneously published in The New England Journal of Medicine including:

The CHAMPION-AF study of the WATCHMAN FLX™ Left Atrial Appendage Closure Device as a first-line option for stroke risk reduction, which met all primary and secondary endpoints and demonstrated superior bleeding risk reduction and similar efficacy of the WATCHMAN FLX device compared to oral anticoagulants in a broad population of patients with non-valvular atrial fibrillation (AF).

The HI-PEITHO clinical trial evaluating the EKOS™ Endovascular System for the treatment of acute pulmonary embolism (PE) in patients with intermediate-risk PE, which demonstrated the EKOS system plus anticoagulation was superior to anticoagulation alone.

Announced positive outcomes from the ADVENT Long-Term Outcomes clinical trial, which demonstrated greater long-term AF treatment success, fewer hospital-based arrhythmia interventions and lower repeat ablation rates at four years with FARAPULSE™ Pulsed Field Ablation (PFA) compared to thermal ablation.

Received National Medical Products Association approval in China for the OPAL HDx™ Mapping System, which enables catheter visualization during FARAPULSE PFA procedures.

Published in Chronic Pain and Management Journal outcomes from the 24-month COMFORT clinical trial demonstrating durable and statistically significant pain relief and improved quality of life with peripheral nerve stimulation therapy with the Nalu Neurostimulation System compared to conventional medical management in patients with chronic pain.

Received U.S. Food and Drug Administration 510(k) clearance for the Asurys™ Fluid Management System, designed to provide real-time irrigation management during endoscopic urologic procedures; when used with the LithoVue™ Elite Single-Use Flexible Ureteroscope System, it also supports intrarenal pressure (IRP) management during ureteroscopy.

Completed the acquisition of Valencia Technologies Corporation, a privately held company focused on the development and commercialization of the eCoin® System, an implantable tibial nerve stimulation device for the treatment of urge urinary incontinence.

Q1 2026 Highlights

Q1 2026 Reported Net Sales: $5.203B

Net Sales by Business; Segment Percentage of Total Net Sales

$318M

Uro

$646M

Endo

$736M

Cardiovascular

$3.503B

MedSurg 33%

$578M

$905M

$506M

$1.244B

$268M

Cardiovascular 67%

Reported Net Sales by Segment and Business

Measure

Q1 2026

Q1 2025

Change Y/Y

Reported Net Sales

$1.701B

$1.577B

+7.8%

Adjusted Operating Margin*

31.3%

33.3%

-200 bps

* Represents operating income as a percentage of operational net sales, both based on internally-derived standard currency exchange rates to exclude the impact of foreign currency, which may be updated from year to year. This measure is reported to the chief operating decision maker (CODM) for purposes of making decisions about allocating resources to the segment and assessing its performance. Prior period adjusted operating margin has been restated at constant currency rates to conform to current year presentation.

Q1 2026 Highlights

Growth was driven by strong results across the business and better than anticipated AXIOS performance.

Growth fell short of our expectations, driven primarily by the Stone management and Sacral Neuromodulation franchises.

Within Stone, underperformance was driven by China VBP as well as some key product gaps in the portfolio.

Our Sacral Neuromodulation business continues to see impact from commercial model disruption.

In DBS we saw continued adoption of Cartesia X leads and accelerating uptake of the Illumina 3D programming algorithm in the U.S.

Pain franchise grew mid-teens, inclusive of a strong quarter from Nalu, which closed at the end of January, while Intracept continues to perform well.

MedSurg Performance Summary

Measure

Q1 2026

Q1 2025

Change Y/Y

Reported Net Sales

$3.503B

$3.085B

+13.5%

Adjusted Operating Margin*

32.1%

33.8%

-170 bps

* Represents operating income as a percentage of operational net sales, both based on internally-derived standard currency exchange rates to exclude the impact of foreign currency, which may be updated from year to year. This measure is reported to the CODM for purposes of making decisions about allocating resources to the segment and assessing its performance. Prior period adjusted operating margin has been restated at constant currency rates to conform to current year presentation.

Q1 2026 Highlights

Interventional Cardiology organic growth of 9% was driven by double digit growth in Coronary Therapies, with exceptional strength in AGENT and ongoing momentum with our imaging portfolio.

Vascular Therapies grew 7% organically, driven by double digit growth in TCAR & Varithena, partially offset by VBP on the Arterial business in China.

Watchman: Global net sales +19.2% as reported, +18.8% operational*/organic*

Growth came in below our expectations, with pressure on volumes in the U.S. as the quarter progressed.

International growth of 30% was driven by our innovative portfolio including our expanded OPAL mapping footprint and catheter utilization, with strong double digit PFA growth in EMEA, in a highly competitive environment, supported by the launch of Farapoint.

U.S. growth of 18% was driven by continued expansion of OPAL, strong catheter utilization and Farapoint, which is performing ahead of our expectations and moved into full launch in Q1.

Low-voltage business declined low-teens, with some impact as we navigated our physician advisory and came up against a tough comp with our first quarter 2025 changeouts. High-voltage business declined low-single digits, with some impact from the Middle East conflict.

Diagnostics grew low-double digits, with continued strength across our broad diagnostic portfolio.

Growth driven by our broad offering of cancer therapy technologies.

Cardiovascular Performance Summary

Timeline represents expected launch timing or data presentation.

Broad-based Innovation Pipeline

Our Approach to Corporate Responsibility

SBcoiesntoenfic

Innovative

care

We shape science into meaningful solutions that help people live longer, better lives.

Empowered

people

We invest in our people and unite our diverse communities through global collaboration.

Healthier

planet

We confront climate change and protect the environment to enable people to live healthier lives.

Performance with integrity

Governance and compliance | Risk management | Cybersecurity | Responsible supply chain

(in millions)

Q1 2026 Reported Net Sales

Organic* Growth

vs Q1 2025

Endoscopy

$736

Urology

$646

Neuromodulation

$318

15%

MedSurg

$1,701

Interventional Cardiology and Vascular Therapies

$1,244

Watchman

$506

19%

Electrophysiology

$905

22%

Cardiac Rhythm Management

$578

(3)%

Interventional Oncology & Embolization

$268

15%

Cardiovascular

$3,503

11%

Total Company

$5,203

Guidance Range

Disclosed February 4, 2026

8.5 to 10.0 percent

Q1 2026 Net Sales vs. Q1 2025

in millions, except per share data

GAAP Results

Amortization Expense

Acquisition/ Divestiture-Related Net Charges/ Credits

Restructuring and Restructuring-Related Net Charges/ Credits

Investment Portfolio Net Losses/ Gains and Impairments

EU MDR

Implementation Costs

Deferred Tax Expenses/ Benefits

Adjusted* Results

Net sales

Cost of products sold (excluding amortization expense)

Gross profit

Gross margin

Selling, general and administrative expenses

SG&A as a percentage of sales

Research and development expenses

R&D as a percentage of sales

Royalty expense

Royalty expense as a percentage of sales

Amortization expense

Contingent consideration net expense (benefit) Restructuring net charges (credits)

Operating income (loss)

Operating margin

Other income (expense):

Interest expense Other, net

Income (loss) before income taxes

Income tax expense (benefit)

Net income (loss)

Net income (loss) attributable to noncontrolling interests

Net income (loss) attributable to Boston Scientific common stockholders

Net income (loss) per diluted common share

Weighted average diluted shares outstanding

$ 5,203

$ -

$ 5,203

1,590

1,536

3,614

(27)

(22)

(5)

3,668

69.4 %

70.5 %

1,781

1,707

34.2 %

32.8 %

516

490

9.9 %

9.4 %

0.2 %

232

(30)

2,513

232

2,209

1,101

(232)

(83)

(35)

(7)

1,459

21.2 %

28.0 %

(90)

(0)

(90)

151

137

(22)

1,162

(232)

(47)

(35)

137

(7)

1,347

(176)

(28)

(15)

(3)

(1)

(320)

157

1,339

(205)

(32)

(33)

104

(6)

320

1,190

(2)

$ 1,341

$ (202)

$ (32)

$ (33)

$ 104

$ (6)

$ 320

$ 1,189

$ 0.90

$ (0.14)

$ (0.02)

$ 0.07

$ (0.00)

$ 0.21

$ 0.80

1,495.0

Income Statement Information

Non-GAAP Reconciliation

Three Months Ended March 31, 2026 (unaudited)

Free Cash Flow*

Days Sales Outstanding (DSO)

Mar 2026

Dec 2025

Sep 2025

Jun 2025

Mar 2025

Q1 2026

Q1 2025

$170M

$354M

Days Inventory on Hand (DIOH)

Capital Expenditures

Mar 2026

Dec 2025

Sep 2025

Jun 2025

Mar 2025

177

168

177

159

178

Q1 2026

Q1 2025

$177M

$187M

Working Capital & Cash Flow Metrics

To supplement Boston Scientific's consolidated financial statements presented on a GAAP basis, the Company discloses certain non-GAAP financial measures. These measures are not in accordance with generally accepted accounting principles in the United States.

A reconciliation of these measures to the corresponding GAAP measures follows in the Appendices. In addition, an explanation of the ways in which Boston Scientific management uses these supplemental non-GAAP measures to evaluate its business and the substantive reasons why Boston Scientific management believes that these measures provide useful information to investors is included under "Use of Non-GAAP Financial Measures" in the Company's most recent earnings release filed with the SEC on Form 8-K. This information is not meant to be considered in isolation from or as a substitute for financial information prepared in accordance with GAAP.

Use of Non-GAAP Measures

Year-over-Year Change

Impact of Foreign Currency

(in millions)

2026

2025

Reported Basis

Fluctuations

Operational Basis

MEDSURG SEGMENT:

ENDOSCOPY

UNITED STATES $

446

$ 420

6.2 %

- %

6.2 %

INTERNATIONAL

290

253

14.8 %

(7.0)%

7.7 %

WORLDWIDE $ 736

$ 673

9.4 %

(2.6)%

6.8 %

UROLOGY

UNITED STATES $

465

$ 469

(0.8)%

- %

(0.8)%

INTERNATIONAL

182

165

10.3 %

(6.1)%

4.3 %

WORLDWIDE $ 646

$ 633

2.1 %

(1.6)%

0.5 %

NEUROMODULATION

UNITED STATES $

236

$ 204

15.7 %

- %

15.7 %

INTERNATIONAL

22.5 %

(7.8)%

14.7 %

WORLDWIDE $ 318

$ 271

17.4 %

(1.9)%

15.4 %

Appendix A - Net Sales Detail - MedSurg

Three Months Ended March 31, 2026 and 2025

Year-over-Year Change

Impact of Foreign Currency

(in millions)

2026

2025

Reported Basis

Fluctuations

Operational Basis

CARDIOVASCULAR SEGMENT:

Interventional Cardiology & Vascular Therapies

UNITED STATES $

552

$ 467

18.3 %

- %

18.3 %

INTERNATIONAL

692

657

5.2 %

(4.9)%

0.4 %

WORLDWIDE $ 1,244

$ 1,124

10.7 %

(2.9)%

7.8 %

Watchman

462

$ 390

18.3 %

- %

18.3 %

29.2 %

(5.5)%

23.7 %

UNITED STATES $ INTERNATIONAL

WORLDWIDE $ 506 $ 425 19.2 % (0.4)% 18.8 %

Electrophysiology

UNITED STATES

$ 603

$ 511

18.0 %

- %

18.0 %

INTERNATIONAL

302

219

37.8 %

(7.6)%

30.1 %

WORLDWIDE

$ 905

$ 730

23.9 %

(2.3)%

21.7 %

Cardiac Rhythm Management

UNITED STATES

$ 349

$ 358

(2.4)%

- %

(2.4)%

INTERNATIONAL

229

220

4.1 %

(7.0)%

(2.8)%

WORLDWIDE

$ 578

0.1 %

(2.7)%

(2.5)%

Interventional Oncology & Embolization

UNITED STATES

$ 170

$ 142

19.8 %

- %

19.8 %

INTERNATIONAL

13.7 %

(5.9)%

7.8 %

WORLDWIDE

$ 268

$ 228

17.5 %

(2.3)%

15.2 %

CARDIOVASCULAR

UNITED STATES

$ 2,137

$ 1,868

14.4 %

- %

14.4 %

INTERNATIONAL

1,366

1,218

12.2 %

(5.8)%

6.3 %

WORLDWIDE

$ 3,503

$ 3,085

13.5 %

(2.3)%

11.2 %

Appendix A - Net Sales Detail - Cardiovascular

Three Months Ended March 31, 2026 and 2025

Three Months Ended

Adjusted Gross Margin

3/31/2026

3/31/2025

Basis Points Change

Gross Margin, as reported

69.4 %

68.8 %

Non-GAAP adjustments

1.0 %

2.7 %

Gross Margin, adjusted

70.5 %

71.5 %

(100)

Three Months Ended

Adjusted Operating Margin

3/31/2026

3/31/2025

Basis Points Change

Operating Margin, as reported

21.2 %

19.8 %

140

Non-GAAP adjustments

6.9 %

9.1 %

Operating Margin, adjusted

28.0 %

28.9 %

(90)

Appendix B - Statement of Operations

Profitability Margins

Impact of Impact of

Foreign Certain

As Reported

Currency

Operational

Acquisitions/

Organic

(in millions) 2026

2025

Basis

Fluctuations

Basis

Divestitures(1)

Basis

ENDOSCOPY

$ 736

$ 673

9.4 %

(2.6)%

6.8 %

- %

6.8 %

UROLOGY

646

633

2.1 %

(1.6)%

0.5 %

- %

0.5 %

NEUROMODULATION

318

271

17.4 %

(1.9)%

15.4 %

- %

15.4 %

MEDSURG

1,701

1,577

7.8 %

(2.1)%

5.7 %

- %

5.7 %

INTERVENTIONAL CARDIOLOGY & VASCULAR THERAPIES

1,244

1,124

10.7 %

(2.9)%

7.8 %

- %

7.8 %

WATCHMAN

506

425

19.2 %

(0.4)%

18.8 %

- %

18.8 %

ELECTROPHYSIOLOGY

905

730

23.9 %

(2.3)%

21.7 %

- %

21.7 %

CARDIAC RHYTHM MANAGEMENT

578

0.1 %

(2.7)%

(2.5)%

- %

(2.5)%

INTERVENTIONAL ONCOLOGY & EMBOLIZATION

268

228

17.5 %

(2.3)%

15.2 %

- %

15.2 %

CARDIOVASCULAR

3,503

3,085

13.5 %

(2.3)%

11.2 %

- %

11.2 %

NET SALES

$ 5,203 $ 4,663 11.6 %

(2.2)%

9.4 %

- %

9.4 %

(1) There were no applicable acquisitions in the first quarter of 2026 or 2025.

Appendix C - Additional Non-GAAP Reconciliations

Three Months Ended

Free Cash Flow (in millions)

3/31/2026

Cash provided by (used for) operating activities

348

Proceeds on disposals of property, plant and equipment

Purchases of property, plant and equipment and internal use software

(177)

Free Cash Flow $ 170

Estimated Free Cash Flow (in billions) FY 2026

Cash provided by (used for) operating activities $ ~4.9 Purchases of property, plant and equipment and internal use software (0.9) Free Cash Flow $ ~4.0

Appendix C - Additional Non-GAAP Reconciliations

12 Months Ended

Reconciliation of Debt to Adjusted EBITDA (in millions)

Q2 2025

Q3 2025

Q4 2025

Q1 2026

3/31/2026

Net income (loss)

$ 795

$ 755

$ 670

$ 1,339

$ 3,559

Income tax (benefit) expense

146

183

(176)

183

Interest expense

357

Interest income

(3)

(6)

(14)

(15)

(38)

Depreciation expense

111

117

137

118

483

Amortization expense

225

228

232

910

EBITDA

1,364

1,362

1,141

1,588

$ 5,455

Non-GAAP Adjustments

Restructuring and restructuring-related net charges

(credits)

161

330

Goodwill and other intangible asset impairment charges

Investment portfolio net losses (gains)

(2)

(6)

(137)

(120)

Acquisition/divestiture - related net charges (credits)

(92)

143

Litigation-related net charges (credits)

194

EU MDR implementation costs

Adjusted EBITDA

$ 1,487

$ 1,502

$ 1,558

$ 1,540

$ 6,087

Debt

$ 11,029

Debt to Adjusted EBITDA

1.8x

Appendix C - Additional Non-GAAP Reconciliations

Adjusted Operating Margin - by Reportable Segment (in millions, except percentages)

Three Months Ended March 31, 2026

MedSurg

% of net sales of reportable segments

Cardiovascular

% of net sales of reportable segments

Total

Net sales, as reported

$ 1,701

$ 3,503

$ 5,203

Impact of foreign currency fluctuations

(0)

(1)

Net sales of reportable segments

1,700

3,502

5,202

Segment expenses

1,167

68.7 %

2,377

67.9 %

Adjusted operating income of reportable segments(1)

Unallocated amounts:

533

31.3 %

1,125

32.1 %

1,658

Corporate expenses, including hedging activities and impact of foreign currency

fluctuations on operating income of reportable segments (199)

Goodwill and other intangible asset impairment charges, acquisition/divestiture-related net charges (credits), restructuring and restructuring-related net charges

(credits), litigation-related net charges (credits) and EU MDR implementation costs (126)

Amortization expense (232)

Operating income (loss), as reported $ 1,101

(1) Calculated as Net sales of reportable segments less Segment expenses.

Appendix C - Additional Non-GAAP Reconciliations

Adjusted Operating Margin - by Reportable Segment (in millions, except percentages)

Three Months Ended March 31, 2025

MedSurg

% of net sales of reportable segments

Cardiovascular

% of net sales of reportable segments

Total

Net sales, as reported

$ 1,577

$ 3,085

$ 4,663

Impact of foreign currency fluctuations

104

Net sales of reportable segments

1,609

3,157

4,766

Segment expenses

1,074

66.7 %

2,089

66.2 %

Adjusted operating income of reportable segments(1)

Unallocated amounts:

536

33.3 %

1,068

33.8 %

1,604

Corporate expenses, including hedging activities and impact of foreign currency

fluctuations on operating income of reportable segments (255)

Goodwill and other intangible asset impairment charges, acquisition/divestiture-related net charges (credits), restructuring and restructuring-related net charges

(credits), litigation-related net charges (credits) and EU MDR implementation costs (209)

Amortization expense (219)

Operating income (loss), as reported $ 921

(1) Calculated as Net sales of reportable segments less Segment expenses.

Appendix C - Additional Non-GAAP Reconciliations

Adjusted Below-the-Line Expenses (in millions)

Three Months Ended

3/31/2026

Below-the-line expenses, as reported

$ 61

Non-GAAP adjustments

(173)

Below-the-line expenses, adjusted

$ (112)

Three Months Ended

Adjusted Tax Rate

3/31/2026

Tax Rate, as reported

(15.2)%

Non-GAAP adjustments

26.9 %

Tax Rate, adjusted

11.7 %

Appendix C - Additional Non-GAAP Reconciliations

Interventional Cardiology Net Sales Growth (in millions, except percentages)

Three Months Ended 3/31/2026

$ %

Net sales growth, as reported

$ 778

11.7 %

Impact of foreign currency fluctuations

(22)

(3.1)%

Net sales growth, operational

Impact of certain acquisitions/divestitures

756

8.5 %

- %

Net sales growth, organic

$ 756

8.5 %

Vascular Therapies Net Sales Growth (in millions, except percentages)

Three Months Ended 3/31/2026

$ %

Net sales growth, as reported

$ 466

9.1 %

Impact of foreign currency fluctuations

(10)

(2.4)%

Net sales growth, operational

Impact of certain acquisitions/divestitures

456

6.6 %

- %

Net sales growth, organic

$ 456

6.6 %

Three Months Ended

EP U.S. Net Sales Growth

3/31/2026

EP International Net Sales Growth

3/31/2026

Net sales growth, as reported

18.0 %

Net sales growth, as reported

37.8 %

Impact of foreign currency fluctuations

- %

Impact of foreign currency fluctuations

(7.6)%

Net sales growth, operational

Impact of certain acquisitions/divestitures

18.0 %

- %

Net sales growth, operational

Impact of certain acquisitions/divestitures

30.1 %

- %

Net sales growth, organic

18.0 %

Net sales growth, organic

30.1 %

Appendix C - Additional Non-GAAP Reconciliations

Net Sales Guidance

Q2 2026 Estimate Full Year 2026 Estimate

(Low) (High) (Low) (High)

Reported growth

5.5 %

7.5 %

7.0 %

8.5 %

Impact of foreign currency fluctuations

(0.5)%

Operational growth

5.0 %

7.0 %

6.5 %

8.0 %

Impact of certain acquisitions/divestitures

- %

Organic growth

5.0 %

7.0 %

6.5 %

8.0 %

Q2 2026 Estimate

Full Year 2026 Estimate

Earnings per Share Guidance

(Low)

(High)

(Low)

(High)

Adjusted results(1) $ 0.82 $ 0.84 $ 3.34 $ 3.41

Estimated Adjusted Below-the-Line Expenses (in millions) Full Year 2026 Estimate

Below-the-line expenses, adjusted(1)

~440

Estimated Tax Rate

Full Year 2026 Estimate

Tax Rate, adjusted(1)

~12.0%

(1)The company has not provided reconciliations of certain forward-looking adjusted metrics to their respective GAAP measure as it is unable to predict with reasonable certainty and without unreasonable efforts the impact of certain items such as intangible asset impairment charges, acquisition-related charges, restructuring and restructuring-related charges and litigation-related charges. The combined impact of these items is uncertain, dependent on various factors and cannot be predicted with reasonable certainty, and could be material to our GAAP measures of financial results.

Appendix C - Additional Non-GAAP Reconciliations

Atrial Fibrillation

CODM

Chief Operating Decision Maker

CRM

Cardiac Rhythm Management

DIOH

Days Inventory on Hand

DRG

Diagnosis-Related Group Reimbursement

DSO

Days Sales Outstanding

EBITDA

Earnings Before Interest, Taxes, Depreciation, and

EMEA

Europe, the Middle East and Africa

Endo

Endoscopy

Electrophysiology

EPS

Earnings per Share

ERG

Employee Resource Group

ESG

Endoscopic Sleeve Gastroplasty

EU MDR

European Union Medical Device Regulation

FDA

Food and Drug Administration

Full Year

GAAP

Generally Accepted Accounting Principles

ICVT

Interventional Cardiology & Vascular Therapies

IO&E

Interventional Oncology & Embolization

IVL

Intravascular Lithotripsy

LAAC

Left Atrial Appendage Closure

LEED

Leadership in Energy and Environmental Design

Neuromodulation

PCI

Percutaneous Coronary Intervention

PFA

Pulsed Field Ablation

PMDA

Pharmaceuticals and Medical Device Agency

PNS

Peripheral Nerve Stimulation

R&D

Research and Development

SCS

Spinal Cord Stimulation

TCT

Transcatheter Cardiovascular Therapeutics

TAVR

Transcatheter Aortic Valve Replacement

TCAR

Transcarotid Artery Revascularization

VBP

Volume-based Procurement

Watchman

BSX: Acronym Reference Guide

Disclaimer

Boston Scientific Corporation published this content on April 22, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on April 22, 2026 at 11:13 UTC.