Marie Thibault, Alexandra Pang and Sam Eiber met with Boston Scientific Chair, President and CEO Mike Mahoney, along with CFO Jon Monson, Chief Medical Officer Dr. Ken Stein, and Investor Relations Senior Manager Stephanie Zizik. They maintain a “Buy” rating for the Marlborough, Massachusetts-based company following those meetings.
Questions have circled Boston Scientific recently, with the company cutting its 2026 guidance in April. Mahoney said at the time that the company’s guidance change was primarily related to three areas: Electrophysiology (EP), led by the Farapulse pulsed field ablation (PFA) platform, the Watchman left atrial appendage closure (LAAC) device, and Urology.
Farapulse was the root of questions around the company’s previous quarterly performance, with analysts saying sales in EP came up short of expectations as more companies, such as Medtronic, Johnson & Johnson MedTech, Abbott and Kardium all gaining share.
“Investor focus remains on ability to meet near-term expectations for [Boston Scientific’s] key franchises, Farapulse and Watchman,” the analysts wrote. “Management acknowledged the challenges in forecasting these businesses in the midst of changing market dynamics, but expressed confidence in an eventual return to healthy long-term growth across both franchises.”
The analysts say that confidence, plus movement into new markets in faster-growing areas and an “underappreciated” pipeline, according to management, provide optimism moving forward, despite some caution.
“We think the pipeline depth, margin profile, and market positioning support long-term aspirations, but execution over the next 2-3 quarters will be critical to restoring investor confidence,” the analysts wrote. “We remain constructive on BSX given a below-peers valuation multiple, its exposure to faster growing MedTech markets, the extensive product pipeline, and strong profitability.”
More on the Farapulse and Watchman questions
The analysts say Boston Scientific embedded share loss in its 2026 outlook, but reiterated its expectation of maintaining PFA market leadership through mid-2027. Management pointed to the launch of Farawave Ultra in the first half of 2027 as a potential key catalyst for addressing share loss.
Farawave Ultra is a map-and-ablate catheter with the same Farawave form factor and an enhanced mapping and sensing capability. It should enable operators to perform pulmonary vein isolation (PVI) and posterior wall isolation without a separate mapping catheter.
Despite new competition and pricing dynamics, analysts say pricing remains stable for the company in PFA.
“Management emphasized that Farapulse remains the catheter of choice for straightforward ablation procedures, underpinned by its large clinical safety and efficacy database, system simplicity and flexibility, and an open architecture approach,” they said.
Boston Scientific still expects sequentially flat Watchman sales in the second and third quarters. The analysts say they’re keeping a cautious approach in that segment. They say the company attributed deceleration to “noise around recent clinical data and an unintentional preoccupation with the concomitant market.”
The company refocused its commercial operations for Watchman with a new sales segment, the analysts note. That means increased direct-to-patient investment, expanded physician training, and introduced new initiatives to improve hospital efficiency.
Potential catalysts to support long-term recovery include a possible label expansion, potential updates to medical society consensus statements and a potential Medicare coverage revision.
Other catalysts at Boston Scientific and long-range plans
The analysts listed a number of near-term catalysts for Boston Scientific. In 2026 alone, the company expects FDA approval for a leadless pacemaker, an above-the-knee (ATK) intravascular lithotripsy (IVL) rollout, then a below-the-knee (BTK) peripheral IVL launch.
Additionally, they expect a U.S. launch for the Seismiq coronary IVL system in the first half of 2027, along with Farawave Ultra.
In Urology, the analysts note “significant commercial disruption” related to the integration of Axonics. On kidney stones, portfolio gaps previously affected results, the analysts said. However, they expect recent FDA clearance for the Asurys fluid management system and other future launches to support improvement.
Overall, Boston Scientific anticipates below-market growth in Urology in the near-term, improving in the second half of the year.
The company expects more growth to come from its IVL platform, along with the Agent drug-coated balloon (DCB) and Tivus ultrasound system for renal denervation. Management expects a 2028 launch for Tivus, with more mature reimbursement pathways due to its late entry into that market.
Analysts also expect the company’s $14.5 billion acquisition of Penumbra to close by the end of the year. Management also expects the company’s recent investment in TAVR company MiRus to allow it to potentially re-enter the space.
